Clinical Articles

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, and painful joint in the absence of trauma. Causes of acute monoarticular arthritis can rangeRead More

Urgent message: Urgent care providers are valued for their ability to treat nonemergent acute healthcare needs efficiently, but in so doing they are also well positioned to identify other, underlying healthcare issues such as hypertension. Introduction Heart disease is the leading cause of death in the United States and accounts for approximately 24% of all deaths.1 Many known risk factors are associated with heart disease, including high blood pressure. The Centers for Disease Control and Prevention estimates that 46,000 deaths each year may be prevented through effective treatment of hypertension,Read More

Urgent message: Upper respiratory infections (URIs) are the most common presenting complaint in urgent care. Regardless of etiology or provider specialty, antibiotics are prescribed 60% of the time for the treatment of URIs, contributing to drug-resistant respiratory organisms. Employing a multimodal intervention, the authors we were able to appreciate a modest, statistically significant decrease in the rate of antibiotic prescribing among urgent care providers. Introduction Antimicrobial resistance is arguably one of the greatest risks to human health. Multidrug resistant organisms are increasingly providing clinical management challenges to providers in ambulatoryRead More

Urgent message: Acute compartment syndrome (ACS) is an important high-risk diagnosis to exclude when evaluating peripheral extremity injury. Providers must maintain a high clinical index of suspicion with careful attention to the history and mechanics of injury in an urgent care setting to preclude the devastating, rapidly developing sequela of ACS. Missing a case of ACS may result in significant morbidity—and even mortality. Awareness of both subtle and overt signs will ensure the best care of the urgent care patient. There are multiple case reports throughout the literature detailing theRead More

Urgent message: While pediatric elbow injuries can be a simple fix in an urgent care setting, understanding mechanism of injury and recognizing cases where referral is warranted help ensure positive outcomes. Pediatric musculoskeletal injuries comprise approximately 12% of the 10 million annual visits to urgent care centers and emergency departments in the United States. History, physical exam and proper imaging remain the mainstay of diagnosis and treatment of many orthopedic related chief complaints. The purpose of this article is to provide a simple and concise approach to evaluation of commonRead More

Urgent message: The incidence of community-acquired pneumonia (CAP) is seasonal in nature, with a peak during the winter months and a trough in the summer months. In the urgent care setting, primary concerns are risk factors for CAP, as well as current treatment and testing guidelines. Overview Pneumonia is an acute alveolar lung infection that presents with infiltrates upon chest imaging and is often accompanied by fever, cough, sputum production, shortness of breath, and physical findings of consolidation and elevated white blood counts. CAP is defined as pneumonia not acquiredRead More

Urgent message: The prevalence of cancer is increasing—and along with it, malignancy-associated complications. Early recognition and management of these conditions is vital to alleviating patient morbidity and maximizing quality of life. Introduction Cancer is a leading cause of morbidity and mortality throughout the world, accounting for over 580,000 deaths in 2013 in the U.S.1 With an aging population and more effective forms of treatment, the overall prevalence of cancer is increasing. Consequently, acute cancer-related complications are more common.2 For many patients, an oncologic complication will be their initial manifestation ofRead More

Urgent message: Clinicians must be able to determine the cause and severity of injury in patients with neck pain, especially in the very young, whose symptoms vary according to their developmental status, and in the elderly, who have weaker bones and degenerative changes. Introduction Avariety of patients from children to the elderly will present to an urgent care Center with the chief symptom of neck pain. Cervical spine (C-spine) injuries occur in 3.7% of adults who sustain blunt trauma and present to an emergency department (ED), and almost half ofRead More