Image Challenge — June 25, 2026 @NEJMgroup

Uploaded June 2026 | Updated September 2026, 1 week ago

A previously healthy 4-year-old boy presented to the emergency department with leg pain and an inability to bear weight on his left side. While jumping on a trampoline with his father at home, he had leaped higher than usual, landed on his feet, and then felt the leg pain. Physical examination was notable for knee swelling and tenderness to palpation on the left side. What is the most likely mechanism of this injury?

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$HFpEF Explained — Managing HFpEF in Primary Care | NEJM In this second episode of a three-part Double Take miniseries on heart failure with preserved ejection fraction (HFpEF) from the New England Journal of Medicine, Drs. Shah, Khan, Pagidipati, and Lloyd-Jones describe pharmacologic and nonpharmacologic interventions for patients with HFpEF. They discuss how selected drug therapies can also address common coexisting conditions, such as hypertension and diabetes. The importance of monitoring and of implementing individualized lifestyle modifications is highlighted in the video. For further reading, the following articles, referenced in this video, are available at NEJM.org: Empagliflozin in Heart Failure with a Preserved Ejection Fraction (Anker et al., in the October 14, 2021, issue, https://www.nejm.org/doi/full/10.1056/NEJMoa2107038 ); Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Solomon et al., in the October 24, 2024, issue, https://www.nejm.org/doi/10.1056/NEJMoa2407107 ); Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (Kosiborod et al., in the September 21, 2023, issue, https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 ); Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity (Packer et al., in the January 30, 2025, issue, https://www.nejm.org/doi/full/10.1056/NEJMoa2410027 ); and Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction (Solomon et al., in the September 22, 2022, issue, https://www.nejm.org/doi/full/10.1056/NEJMoa2206286 ). Funding for this Double Take is provided by the Doris Duke Foundation, committed to building a creative, equitable, and sustainable future. #medicaleducation #clinicalmedicine #nejm The New England Journal of Medicine is the world’s leading general medical journal. Continuously published for over 200 years, the Journal publishes peer-reviewed research along with interactive clinical content for physicians, educators, and the global medical community at NEJM.org.$

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