Doctors of Reddit, what is a 1 in a million chance thing about your patient you have witnessed?

This reminds me of a similar story I had with last second, off-chance exam/history findings.

Old woman comes in with a complaint of vague intermittent headaches, nothing particularly outstanding on physical exam. She describes something that sounds like migraine auras as well as unilateral pain in the left side of her head when it happens. Attending I'm with treats it as migraines, gives her reassurance and sends her on her way.

At the desk checking out the nurse doing the paperwork offers a some candy from a jar. She says something like "oh no honey my jaw gets really painful and won't open if I eat something chewy." Doc overhears and immediately pulls her back in to get more info. Turns out the "migraine auras" we thought she was describing were actual transient losses of vision in her left eye, and the jaw pain was intermittent claudication.

He ordered the "standard" blood work based on our new suspicions to be done ASAP. She had a massively elevated ESR (which indicates systemic inflammation) and on further investigation she was found to have Giant Cell (Temporal) Arteritis.

If left untreated the momentary losses of vision will become permanent and you will go blind. Super good catch by the attending.

/r/AskReddit Thread Parent