Missionary medicine is challenging in many ways. Our limited diagnostic capabilities at times makes accurately diagnosing patient's conditions very difficult.
This little boy presented with a month's history of swelling of his hands and feet. His dad was concerned because he wasn't walking, due to the swelling. On exam, this cute little kid had hard masses of his feet and hands. Xrays show significant changes of his bones, something you might see after an infection or a fracture - none of which he had.

