Clinical Articles

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
Urgent message: Being able to recognize the distinct oral lesions of common illnesses in children is essential, but it can be difficult to conduct an oral examination in frightened young children. Introduction Inspecting intraoral lesions in children will often confirm a diagnosis, but getting uncooperative patients to let the clinician visualize such lesions is challenging. Here we provide helpful examination tips and review common pediatric infectious and allergic oral lesions and their treatment.Read More
Early Diabetes Screening in the Urgent Care, Part 2
Urgent message: The findings of a quality-improvement study show the usefulness of a screening pathway for early detection of type 2 diabetes mellitus in adult patients of an urgent care center. Abstract Background: Undiagnosed diabetes affects over 9 million Americans, with over 79 million estimated to have blood glucose levels in the range of prediabetes. Various methods have been suggested to screen for undiagnosed diabetes in the asymptomatic population, although a consensus about the best evidence-based approach, especially in settings outside primary care, is required. Objective: We evaluated the usefulnessRead More
Abdominopelvic Pain, Part 2: Approach to Women in the Urgent Care Setting
Urgent message: Diagnosis of abdominal pain is more complex in women than in men because of the more complex anatomy involved. Using a stepwise approach and involving patients in their care can make a difference. Introduction Part 1 of this article [see “Abdominopelvic Pain, Part 1: Approach to Men in the Urgent Care Setting,” at approach-men-urgent-care-setting/] explained that finding the cause of abdominopelvic pain can be a difficult task for any health-care provider because the diagnostic process is riddled with important decisions. This second part of the article focuses on causes of pain specific to women, and then discussesRead More