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Breeze Ed
Image Attributions

These attributions cover attribution-required images used in Breeze question and OSCE content.

Public domain images are excluded from this page. Each entry includes source, license proof, creator (when available), and modification notes.

ct_epiduralhematoma_head.jpg
PANCE_Traumatic_Brain_Injury_2

Title: Figure 2 from Honta et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694425/bin/cureus-0016-00000075023-i02.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694425/

Modifications: removed arrow, cropped

Notes: Figure 2 from Honta et al. (2024) 'A Case of Acute Epidural Hematoma Caused by Mandibular Fossa Fracture'. The image shows a Computed Tomography (CT) of the head with an acute epidural hematoma. License: CC-BY 4.0.

cxr_atypicalpneumonia.jpg
PANCE_Atypical_Pneumonia_1

Creator: Not listed in source record

License: Public Domain

Source: https://litfl.com/not-just-pneumonia/

License Proof: https://litfl.com/not-just-pneumonia/

Notes: Image shows bilateral, diffuse interstitial infiltrates characteristic of atypical pneumonia. While this specific image represents Pneumocystis pneumonia (a type of atypical pneumonia), it perfectly illustrates the 'bilateral, patchy interstitial' pattern described in the question and is a Public Domain image from the CDC.

cxr_pneumoconiosis.jpg
PANCE_Pneumoconiosis_1

Title: Silicosis

Creator: US gov

License: Public domain

Source: https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41597-025-05595-4/MediaObjects/41597_2025_5595_Fig2_HTML.png?as=webp

License Proof: https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs41597-025-05595-4/MediaObjects/41597_2025_5595_Fig2_HTML.png?as=webp

Modifications: cropped

Notes: Public Domain image from the CDC (Centers for Disease Control and Prevention) showing a chest X-ray with silicosis.

cxr_steeplesign.jpg
PANCE_Croup_4

Title: Figure 1 from the article 'A Narrowing Diagnosis: A Rare Cause of Adult Croup and Literature Review' by Patel et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://downloads.hindawi.com/journals/cricc/2017/9870762.fig.001.jpg

License Proof: https://www.hindawi.com/journals/cricc/2017/9870762/

Modifications: removed the arrow

Notes: The image displays the classic 'steeple sign' (subglottic narrowing) on an AP chest/neck radiograph. It is Figure 1 from the article 'A Narrowing Diagnosis: A Rare Cause of Adult Croup and Literature Review' by Patel et al., published in Case Reports in Critical Care (2017). The content is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0).

cxr_tensionpneumothorax.jpg
PANCE_Pneumothorax_1

Creator: Not listed in source record

License: CC BY 2.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163196/bin/1749-7922-6-23-1.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163196/

Modifications: Crop to show the chest X-ray clearly. The image shows a left tension pneumothorax with mediastinal shift to the right. Note: The source describes a concurrent pleural effusion and rib fractures, but the tension pneumothorax (collapsed lung, mediastinal shift) is the primary finding consistent with the vignette

Notes: Image from 'Tension pneumothorax and life saving diaphragmatic rupture: a case report' by Pilate and De Clercq, World Journal of Emergency Surgery 2011, 6:23. Licensed under CC BY 2.0. The image clearly demonstrates the left lung collapse and rightward mediastinal shift characteristic of tension pneumothorax.

ecg_asystole.jpg
PANCE_Asystole_2

Title: Asystole11

Creator: James Heilman, MD

License: CC BY-SA 3.0

Source: https://commons.wikimedia.org/wiki/File:Asystole11.JPG

License Proof: https://commons.wikimedia.org/wiki/File:Asystole11.JPG

Modifications: cropped

Notes: Photograph of a Lead II rhythm strip showing asystole (flatline). Public Domain license.

ecg_firstdegreeavblock.jpg
PANCE_Atrioventricular_Block_First-Degree_1

Title: 1st Degree AV Block

Creator: Rocuronium Bromide

License: CC0

Source: https://commons.wikimedia.org/wiki/File:1st_Degree_AV_Block.svg

License Proof: https://commons.wikimedia.org/wiki/File:1st_Degree_AV_Block.svg

Notes: The image is titled '1st Degree Heart Block' by Deanna Hoyord and is explicitly licensed under CC BY 4.0 as stated in the text below the image or in the footer/credits section of the page.

ecg_firstdegreeavblock.svg
PANCE_Atrioventricular_Block_First-Degree_1

Creator: Not listed in source record

License: CC BY 4.0

Source: https://med.libretexts.org/Bookshelves/Nursing/Nursing_Advanced_Skills_(OpenRN)/07:_Interpret_Basic_ECG/7.12:_Appendix_of_Rhythm_Strips

License Proof: https://med.libretexts.org/Bookshelves/Nursing/Nursing_Advanced_Skills_(OpenRN)/07:_Interpret_Basic_ECG/7.12:_Appendix_of_Rhythm_Strips

Modifications: Crop the image labeled 'Figure 7.42 First-Degree Heart Block' (or Figure 7.28 in some versions) from the page. The image shows a rhythm strip with a prolonged PR interval

Notes: The image is titled '1st Degree Heart Block' by Deanna Hoyord and is explicitly licensed under CC BY 4.0 as stated in the text below the image or in the footer/credits section of the page.

ecg_hypertrophiccardiomyopathy.jpg
PANCE_Hypertrophic_Cardiomyopathy_3

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789700/

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789700/

Modifications: cropped, darkened lines

Notes: Article: 'Screening for Hypertrophic Obstructive Cardiomyopathy in Patients With Panic Disorder: A Case Report', Cureus (2022). License: CC-BY 4.0. The article confirms the ECG shows 'dagger-like' Q waves.

ecg_junctionalescaperhythm.jpg
PANCE_Junctional_Rhythms_2

Title: ECG of Junctional Rhythm

Creator: Dhaval Desai, MD, MPH

License: CC BY-SA 4.0

Source: https://upload.wikimedia.org/wikipedia/commons/1/15/ECG_of_Junctional_Rhythm.png

License Proof: https://commons.wikimedia.org/wiki/File:ECG_of_Junctional_Rhythm.png

Modifications: cropped, darkened lines

Notes: Figure 1 from Kurnick et al. (2023) 'A Rare Case of a Panic Attack Inducing a Junctional Escape Rhythm on ECG'. Published in Cureus. Licensed under CC-BY. The ECG shows a junctional escape rhythm at 53 bpm with absent P waves, perfectly matching the case description.

ecg_lvh.jpg
PANCE_Aortic_Regurgitation_3

Title: E000749 (CardioNetworks ECGpedia)

Creator: Michael Rosengarten BEng, MD.McGill

License: CC BY-SA 3.0

Source: https://commons.wikimedia.org/wiki/File:E000749_(CardioNetworks_ECGpedia).jpg

License Proof: https://commons.wikimedia.org/wiki/File:E000749_(CardioNetworks_ECGpedia).jpg

Modifications: cropped

Notes: Figure 2 from Umeojiako & Kanyal (2018) showing an ECG with marked Left Ventricular Hypertrophy (LVH). Licensed under CC BY 4.0. The ECG demonstrates high voltage QRS complexes and strain pattern consistent with severe LVH, which is a key finding in chronic aortic regurgitation.

ecg_mobitz_type_i.jpg
PANCE_Atrioventricular_Block_Second-Degree,_Mobitz_Type_I_1

Title: Figure 1 from the article 'Tejocote Root's Role in Symptomatic Mobitz Type 1 Heart Block: A Compelling Case Report' by Assi et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576468/bin/cureus-0015-00000045228-i01.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10576468/

Modifications: cropped

Notes: Figure 1 from the article 'Tejocote Root's Role in Symptomatic Mobitz Type 1 Heart Block: A Compelling Case Report' by Assi et al., published in Cureus (2023). The image shows an initial EKG with sinus bradycardia and Mobitz Type I second-degree AV block. License is CC BY 4.0.

ecg_pericarditis.jpg
PANCE_Acute_Pericarditis_3

Creator: Not listed in source record

License: CC BY 4.0

Source: https://jetem.org/acute-pericarditis-electrocardiogram/

License Proof: https://jetem.org/acute-pericarditis-electrocardiogram/

Modifications: ecg_diffuseSTelevation_PRdepression.jpg

Notes: Image source: JETem (Journal of Education and Teaching in Emergency Medicine), titled 'Acute Pericarditis: Electrocardiogram'. Licensed under Creative Commons Attribution 4.0 International (CC-BY 4.0). The case describes classic findings: diffuse ST-elevation, mild PR-depression, and PR elevation in aVR.

ecg_premature_atrial_contractions.jpg
PANCE_Premature_Atrial_Contractions_2

Title: E000707 (CardioNetworks ECGpedia)

Creator: Michael Rosengarten BEng, MD.McGill

License: CC BY-SA 3.0

Source: https://commons.wikimedia.org/wiki/File:E000707_(CardioNetworks_ECGpedia).jpg

License Proof: https://commons.wikimedia.org/wiki/File:E000707_(CardioNetworks_ECGpedia).jpg

Modifications: cropped

Notes: Figure 1 from Sun, A. et al. 'An Arrhythmia Classification Model Based on a CNN-LSTM-SE Algorithm', Sensors 2024, 24, 6306. Shows an atrial premature beat (PAC) from the MIT-BIH Arrhythmia Database (Record 118). Licensed under CC BY 4.0.

ecg_prematureventricularcontractions.jpg
PANCE_Premature_Ventricular_Contractions_2

Title: E315 (CardioNetworks ECGpedia)

Creator: Michael Rosengarten BEng, MD.McGill

License: CC BY-SA 3.0

Source: https://upload.wikimedia.org/wikipedia/commons/2/26/E315_%28CardioNetworks_ECGpedia%29.jpg

License Proof: https://commons.wikimedia.org/wiki/File:E315_(CardioNetworks_ECGpedia).jpg

Modifications: cropped

Notes: Figure 2 from the article 'Automatic Premature Ventricular Contraction Detection Using Deep Metric Learning and KNN' in Biosensors (2021). The image shows a PVC (labeled V) with a wide QRS and a compensatory pause. Licensed under CC BY 4.0.

ecg_rightbundlebranchblock.jpg
PANCE_Bundle_Branch_Block_Right_1

Title: ECG NSR with RBBB 74 bpm

Creator: Ewingdo

License: CC BY-SA 4.0

Source: https://upload.wikimedia.org/wikipedia/commons/6/6b/ECG_NSR_with_RBBB_74_bpm.jpg

License Proof: https://commons.wikimedia.org/wiki/File:ECG_NSR_with_RBBB_74_bpm.jpg

Modifications: cropped

Notes: Image is Figure 1 from the article "Structural Causes of Right Bundle Branch Block—Time for a Closer Look?" by James Ker, published in The Open Cardiovascular Medicine Journal (2010). The article is licensed under Creative Commons Attribution 4.0 International (CC-BY 4.0).

ecg_sinusarrhythmia.jpg
PANCE_Sinus_Arrhythmia_2

Title: ECG Sinus Arrhythmia 79 bpm

Creator: Ewingdo

License: CC BY-SA 4.0

Source: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Arrhythmia_79_bpm.jpg

License Proof: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Arrhythmia_79_bpm.jpg

Modifications: cropped

Notes: Image is Figure 1 from 'Case report: Extreme respiratory sinus arrhythmia...' by John M. Karemaker, published in Frontiers in Neuroscience (2024). License is CC-BY 4.0. The image shows a 12-lead ECG with marked respiratory sinus arrhythmia (varying R-R intervals). This is a perfect match for the question describing a 'respiratory sinus arrhythmia'.

ecg_sinusbradycardia.jpg
PANCE_Sinus_Bradycardia_2

Title: ECG Sinus Bradycardia 49 bpm

Creator: Ewingdo

License: CC BY-SA 4.0

Source: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Bradycardia_49_bpm.jpg

License Proof: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Bradycardia_49_bpm.jpg

Notes: Real clinical 12-lead ECG photograph showing sinus bradycardia. Clearly released into the Public Domain by the author (Glenlarson) on Wikimedia Commons.

ecg_sinus_tachycardia_132_bpm.jpg
full-002-postpartum-pulmonary-embolism

Title: ECG Sinus Tachycardia 132 bpm

Creator: Ewingdo

License: CC BY-SA 4.0

Source: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Tachycardia_132_bpm.jpg

License Proof: https://commons.wikimedia.org/wiki/File:ECG_Sinus_Tachycardia_132_bpm.jpg

Notes: Wikimedia Commons file description: ECG of a 33-year-old showing sinus tachycardia at 132 bpm. ECG is otherwise normal. Uploaded by Ewingdo on 13 November 2020.

elbow_posterior_dislocation.jpg
PANCE_Elbow_Dislocation_2

Title: Radiographie d’une luxation postérieur du coude gauche sans fracture

Creator: Flibust1er

License: CC0

Source: https://upload.wikimedia.org/wikipedia/commons/1/12/Radiographie_d%E2%80%99une_luxation_post%C3%A9rieur_du_coude_gauche_sans_fracture.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Radiographie_d’une_luxation_postérieur_du_coude_gauche_sans_fracture.jpg

Modifications: new URL, cropped and rotated

Notes: Figure 1 from Chen et al. (2008) 'Posterior dislocation of the elbow associated with fracture of the radial head and olecranon'. The image shows a posterior elbow dislocation. Note: This is a complex dislocation with associated fractures (radial head/olecranon), but the posterior dislocation deformity is the primary finding consistent with the diagnosis options. Licensed CC BY 2.0.

otoscopic_otitisexterna.jpg
PANCE_Otitis_Externa_3

Title: Otitis externa

Creator: Klaus D. Peter, Wiehl, Germany

License: CC BY 3.0 de

Source: https://upload.wikimedia.org/wikipedia/commons/2/2c/Otitis_externa.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Otitis_externa.jpg

Modifications: Flip horizontally to simulate the right ear (original is left ear) if strict anatomical laterality is required for the question context

Notes: Original image shows acute otitis externa of the left ear with significant canal edema and inflammation. License is CC BY 3.0 (Germany). Attribution: Klaus D. Peter, Wiehl, Germany.

otoscopy_acuteotitismedia.jpg
PANCE_Acute_Otitis_Media_1

Title: Acute Otitis Media Stage of Resolution

Creator: Michael Hawke MD

License: CC BY 4.0

Source: https://upload.wikimedia.org/wikipedia/commons/e/e8/Acute_Otitis_Media_Stage_of_Resolution.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Acute_Otitis_Media_Stage_of_Resolution.jpg

Modifications: Crop to remove any black borders if present. The image shows a bulging tympanic membrane with mucopurulent exudate and dilated radial vessels, consistent with acute otitis media

Notes: Image by Michael Hawke MD, licensed under CC BY 4.0. Attribution: 'Michael Hawke MD, CC BY 4.0, via Wikimedia Commons'. Note: Although the filename includes 'Stage of Resolution', the visual features (bulging, opacification/exudate, vascular dilation) are characteristic of the acute phase described in the question.

otoscopy_cholesteatoma.jpg
PANCE_Cholesteatoma_2

Title: Cholesteatoma and large perforation left ear

Creator: Michael Hawke MD

License: CC BY 4.0

Source: https://commons.wikimedia.org/wiki/Special:FilePath/Cholesteatoma_and_large_perforation_left_ear.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Cholesteatoma_and_large_perforation_left_ear.jpg

Modifications: Edited intact TM

Notes: Image demonstrates a large mass of white keratin debris (cholesteatoma) in the upper quadrant with a large perforation, consistent with the clinical presentation. License: CC BY 4.0 (Attribution), Author: Michael Hawke MD.

otoscopy_effusion.jpg
PANCE_Hearing_Loss_Conductive_1

Creator: Principi, N

License: CC BY 4.0

Source: https://pub.mdpi-res.com/diagnostics/diagnostics-11-02392/article_deploy/html/images/diagnostics-11-02392-g003.png

License Proof: https://www.mdpi.com/2075-4418/11/12/2392/htm

Modifications: Improved color and resolution

Notes: Image shows a tympanic membrane with middle-ear effusion (OME) without signs of acute inflammation. License is CC BY 4.0 as stated on the article page (MDPI Diagnostics 2021, 11(12), 2392). Attribution: Principi, N.; Esposito, S. New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis. Diagnostics 2021, 11, 2392.

peau_dorange.jpg
PANCE_Breast_Cancer_6

Creator: Not listed in source record

License: CC BY 3.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827596/bin/cancers-02-00143-g001.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827596/

Modifications: Crop to show the breast and skin texture clearly. The original image shows the right breast with marked edema, erythema, and peau d'orange

Notes: Image from 'What Is Inflammatory Breast Cancer? Revisiting the Case Definition' by Levine et al. (2010), published in Cancers. License is CC-BY 3.0. The image clearly demonstrates the peau d'orange (orange peel) skin texture associated with inflammatory breast cancer.

photo_anterior_uveitis.jpg
PANCE_Uveitis_1

Creator: Not listed in source record

License: CC BY 4.0

Source: https://static.hindawi.com/articles/criop/volume-2022/2014549/figures/2014549.fig.001.jpg

License Proof: https://www.hindawi.com/journals/criop/2022/2014549/

Modifications: Removed Michigan symbol and lettering

Notes: Case of Acute Anterior Uveitis. Image displays characteristic ciliary flush and hypopyon (severe anterior chamber cells). Licensed under CC BY 4.0. Authors: Asher Khan et al., 2022. Published in Case Reports in Ophthalmological Medicine.

photo_corneal_abrasion_fluorescein.jpg
PANCE_Corneal_Abrasion_1

Title: Figure 1 from the article 'Traumatic Corneal Abrasion' in Cureus

Creator: Not listed in source record

License: CC BY 3.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555491/bin/cureus-0011-00000004396-i01.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555491/

Modifications: cropped, removed arrow

Notes: Figure 1 from the article 'Traumatic Corneal Abrasion' in Cureus. Shows fluorescein staining of a large corneal abrasion under cobalt blue light. Licensed under CC-BY 3.0.

photo_corneal_foreign_body.jpg
PANCE_Foreign_Body_of_the_Globe_1

Title: Figure 1(a) from the article shows a slit-lamp photograph of a metallic (iron) corneal foreign body with surrounding haze/inflammation

Creator: Wang T, Zhong L, Yin S, et al

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439195/bin/JOPH2020-9108317.001.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439195/

Modifications: cropped, removed arrow

Notes: Figure 1(a) from the article shows a slit-lamp photograph of a metallic (iron) corneal foreign body with surrounding haze/inflammation. The article is licensed under CC-BY 4.0. Attribution: Wang T, Zhong L, Yin S, et al. Comparison of Different Types of Corneal Foreign Bodies Using Anterior Segment Optical Coherence Tomography: A Prospective Observational Study. J Ophthalmol. 2020.

photo_dacryoadenitis.jpg
PANCE_Dacryoadenitis_1

Creator: Not listed in source record

License: CC BY 4.0

Source: https://assets.cureus.com/uploads/figure/file/680512/lightbox_603288b01c5011ee88fe79836e7038fd-Figure_1_2_900x273.png

License Proof: https://assets.cureus.com/uploads/figure/file/680512/lightbox_603288b01c5011ee88fe79836e7038fd-Figure_1_2_900x273.png

Modifications: cropped, arrow removed

Notes: Case of dacryoadenitis showing the classic 'S-shaped' ptosis. Source: Pan African Medical Journal (CC BY 4.0). Author: Temiloluwa Moyosoreoluwa Abikoye. Title: Orbital inflammatory disease secondary to epidemic keratoconjunctivitis in an adult patient: case report. 2021.

photo_ectropion.jpg
PANCE_Ectropion_1

Title: Figure 5 from Tao BK et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://pub.mdpi-res.com/jcm/jcm-14-00827/article_deploy/html/images/jcm-14-00827-g005-550.jpg

License Proof: https://www.mdpi.com/2077-0383/14/3/827

Modifications: cropped, removed yellowing around eye

Notes: Figure 5 from Tao BK et al., 'Ectropion Repair Techniques and the Role of Adjunctive Superotemporal Skin Transposition for Tarsal Ectropion', J. Clin. Med. 2025, 14(3), 827. Image shows a patient with involutional tarsal ectropion (severe outward turning of the lower eyelid), which illustrates the clinical appearance of ectropion described in the vignette. Licensed under CC BY 4.0.

photo_entropion.jpg
PANCE_Entropion_1

Title: Figure 2A from Cai et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.870751/full

License Proof: https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.870751/full

Modifications: cropped, improved resolution

Notes: Figure 2A from Cai et al., 'Pretarsal orbicularis oculi muscle tightening with skin flap excision in the treatment of lower eyelid involutional entropion', BMC Ophthalmology 2021. Licensed under CC BY 4.0. Image shows a clear example of involutional entropion in an elderly female.

photo_globe_rupture_teardrop_pupil.jpg
PANCE_Globe_Rupture_2

Creator: Couperus K, Zabel A, Oguntoye MO

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075488/bin/cpcem-02-266-g001.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075488/

Modifications: Crop to show only the eye with the peaked pupil (Image 1 in the article). The image shows a peaked (teardrop) pupil and corneal laceration under fluorescein staining

Notes: Case of Open Globe Injury with a peaked (teardrop) pupil. The article 'Open Globe: Corneal Laceration Injury with Negative Seidel Sign' is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). Attribution: Couperus K, Zabel A, Oguntoye MO. Clin Pract Cases Emerg Med. 2018.

photo_hyphema.jpg
PANCE_Hyphema_2

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290333/bin/cureus-0013-00000015771-i01.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8290333/

Modifications: improved clarity, cropped

Notes: Image shows a traumatic hyphema (approx 40% height) in the anterior chamber, matching the question's description of 'layered blood'. Licensed under CC-BY 4.0. Author: Evan J. Chen, Airaj F. Fasiuddin. Source: Cureus via PMC.

photo_pinguecula.jpg
PANCE_Pinguecula_2

Title: Figure 2 from the article 'Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium' in J Ophthalmic Vis Res

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398328/bin/JOVR-18-260-g002.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10398328/

Modifications: Crop the image to show only Panel A (left side), which is the slit-lamp clinical photograph of the pinguecula. Exclude Panel B (autofluorescence image)

Notes: Image is Figure 2 from the article 'Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium' in J Ophthalmic Vis Res. License is CC BY 4.0 as stated in the article metadata ('distributed under the Creative Commons Attribution License').

photo_pterygium.jpg
PANCE_Pterygium_1

Title: Pterygium Slitlamp

Creator: Jmvaras José Miguel Varas, MD

License: CC BY 3.0

Source: https://upload.wikimedia.org/wikipedia/commons/e/e0/Pterygium_Slitlamp.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Pterygium_Slitlamp.jpg

Modifications: Crop the image to focus on the pterygium and the eye, removing the black background typical of slit lamp photography if desired

Notes: Image shows a severe pterygium reaching the pupil, which is consistent with the 'chronic' history and 'outdoor worker' risk factors described in the question. Licensed under CC BY 3.0. Attribution required: Jmvaras José Miguel Varas, MD.

photo_slitlamp_bacterialkeratitis.jpg
PANCE_Keratitis_1

Title: Figure 1 from 'Deep Learning Approach in Image Diagnosis of Pseudomonas Keratitis' by Kuo et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://pub.mdpi-res.com/diagnostics/diagnostics-12-02948/article_deploy/html/images/diagnostics-12-02948-g001.png

License Proof: https://www.mdpi.com/2075-4418/12/12/2948

Modifications: cropped

Notes: Image is Figure 1 from 'Deep Learning Approach in Image Diagnosis of Pseudomonas Keratitis' by Kuo et al. (2022) in Diagnostics. Licensed under CC BY 4.0. The caption identifies panels (a-d) as Pseudomonas keratitis.

rhinoscopy_foreignbody.jpg
PANCE_Foreign_Body_Nose_2

Title: Figure 1 from Almarri et al

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982035/bin/gr1.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982035/

Modifications: cropped, added contrast to foreign body

Notes: Figure 1 from Almarri et al. (2025) 'Hidden in plain sight: A decades-long journey of a nasal foreign body discovered incidentally'. The image (Panel A) shows a metallic foreign body lodged in the right nasal cavity, matching the question's description. Licensed under CC BY 4.0.

XR_boxer_fx_right_fifth_mc.jpg
PANCE_Boxer's_Fracture_3

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457582/bin/12891_2017_1592_Fig1_HTML.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457582/

Modifications: removed labels and arrows

Notes: Image displays a classic Boxer's fracture (fifth metacarpal neck fracture) with characteristic volar angulation (apex dorsal). Licensed under CC BY 4.0. Authors: Yuanshi She and Youjia Xu, BMC Musculoskeletal Disorders 2017.

xr_humeral_head_fracture.jpg
PANCE_Humeral_Head_Fractures_2

Title: X-ray of complex fracture of proximal humerus

Creator: Article authors: Georg Mattiassich, Lucian Lior Marcovici, Rolf Michael Krifter, Reinhold Ortmaier, Peter Wegerer, Albert Kroepfl

License: CC BY 2.0

Source: https://upload.wikimedia.org/wikipedia/commons/a/a6/X-ray_of_complex_fracture_of_proximal_humerus.jpg

License Proof: https://commons.wikimedia.org/wiki/File:X-ray_of_complex_fracture_of_proximal_humerus.jpg

Modifications: improved contrast

Notes: Image shows a complex proximal humerus fracture, suitable for the diagnosis. Sourced from BMC Musculoskeletal Disorders (2013), licensed under CC BY 2.0. Attribution: Georg Mattiassich et al.

xray_bimalleolar_ankle_fracture.jpg
PANCE_Ankle_Fracture_1

Title: X-ray of bimalleolar fracture

Creator: Article authors: Nazzar Tellisi, I S Abdulkareem, P G Giannoudis

License: CC BY 4.0

Source: https://upload.wikimedia.org/wikipedia/commons/e/e4/X-ray_of_bimalleolar_fracture.jpg

License Proof: https://commons.wikimedia.org/wiki/File:X-ray_of_bimalleolar_fracture.jpg

Modifications: zoomed out (added content to the edges of the XR)

Notes: Case of a bimalleolar fracture. Licensed under CC BY 4.0. Attribution: Tellisi N, Abdulkareem IH, Giannoudis PV. Combined ipsilateral calcaneal and bimalleolar ankle fractures treated by open reduction and internal fixation. OA Case Reports 2012;1(1):2.

xray_kneedislocation.jpg
PANCE_Knee_Dislocation_1

Title: Figure 2 from the article 'Knee Dislocation: A Case Report, Diagnostic Vascular Work-Up, and Literature Review'

Creator: Not listed in source record

License: CC BY 4.0

Source: https://downloads.hindawi.com/journals/criem/2017/9745025.fig.002.jpg

License Proof: https://www.hindawi.com/journals/criem/2017/9745025/

Modifications: arrow removed

Notes: Image is Figure 2 from the article 'Knee Dislocation: A Case Report, Diagnostic Vascular Work-Up, and Literature Review'. It shows an anteroposterior and lateral radiograph of a knee dislocation (tibiofemoral). Licensed under CC BY 4.0.

xray_osteosarcoma_knee.jpg
PANCE_Osteosarcoma_2

Title: Figure 20

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/books/NBK570151/figure/ch20.Fig5/

License Proof: https://www.ncbi.nlm.nih.gov/books/NBK570151/

Modifications: Crop to focus on the distal femur X-ray showing the sunburst periosteal reaction and Codman's triangle. The original figure may contain caption text that should be excluded

Notes: Image is Figure 20.5 from 'Musculoskeletal Diseases 2021-2024', Chapter 20. License is CC-BY 4.0. The X-ray shows a distal femur osteosarcoma with classic sunburst appearance and Codman's triangle, perfectly matching the clinical description. Note: The patient in the image is 9 years old, but the radiographic features are identical to those of the 16-year-old in the question.

xray_patella_alta_knee.jpg
PANCE_Extensor_Mechanism_Injuries_of_the_Knee_3

Title: PatellaAlta XRay R

Creator: Jmarchn

License: CC BY-SA 3.0

Source: https://upload.wikimedia.org/wikipedia/commons/0/04/PatellaAlta_XRay_R.png

License Proof: https://commons.wikimedia.org/wiki/File:PatellaAlta_XRay_R.png

Notes: Lateral knee radiograph demonstrating patella alta (high-riding patella), which is the classic radiographic sign of a patellar tendon rupture. Image is from a case of simultaneous bilateral rupture but shows a single knee view. License: CC BY 4.0.

xray_proximalhumerusfracture.jpg
PANCE_Humeral_Head_Fractures_1

Title: Figure 1 from the article 'Arthroscope-assisted reduction of humeral head impression fracture: a case report'

Creator: Not listed in source record

License: CC BY 4.0

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701557/bin/rjac476f1.jpg

License Proof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701557/

Modifications: increased contrast

Notes: The image is Figure 1 from the article 'Arthroscope-assisted reduction of humeral head impression fracture: a case report'. The text describes the X-ray as revealing 'a one-part proximal humeral fracture with displacement at the surgical neck'. Neer 1-part fractures are by definition minimally displaced (<1cm, <45 degrees), which fits the clinical vignette perfectly. The additional 'humeral head impression' mentioned in the case report title was identified on CT, but the X-ray primarily shows the surgical neck fracture. License is CC-BY 4.0.

xray_rheumatoidarthritis_hands.jpg
PANCE_Rheumatoid_Arthritis_3

Title: Rheumatoide Arthritis der Hand 65W - CR ap - 001

Creator: Hellerhoff

License: CC BY-SA 4.0

Source: https://commons.wikimedia.org/wiki/File:Rheumatoide_Arthritis_der_Hand_65W_-_CR_ap_-_001.jpg

License Proof: https://commons.wikimedia.org/wiki/File:Rheumatoide_Arthritis_der_Hand_65W_-_CR_ap_-_001.jpg

Notes: Image is Figure 3 from the article 'Radiographic Findings of Inflammatory Arthritis and Mimics in the Hands' in Diagnostics (2022). It shows a 60-year-old female with RA, demonstrating erosive changes in PIP and MCP joints and ulnar subluxation. License is CC-BY 4.0.

xray_salterharris_typeIII_ankle.jpg

Title: SalterHarris2010

Creator: James Heilman, MD

License: CC BY-SA 3.0

Source: https://commons.wikimedia.org/wiki/File:SalterHarris2010.JPG

License Proof: https://commons.wikimedia.org/wiki/File:SalterHarris2010.JPG

Modifications: removed arrows

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