Textbook of Urgent Care Medicine, Chapter 32 Lower Extremity Pain and Injury
Original authors: Christopher M. Prior, Matthew Speer, and John Shufeldt Originally published in 2014. Substantially updated and clinically reviewed in 2026 to reflect current evidence, guidelines, and urgent care practice. Introduction Lower extremity injuries are common in the urgent care setting. Rapid triage, evaluation, and treatment are paramount in order to move a typical urgent care center’s volume of patients. The history of acute trauma resulting in a painful or swollen extremity focuses the evaluation …
Read MoreTextbook of Urgent Care Medicine, Chapter 31, Ankle and Foot Pain and Injury
Original author: Robert Truax Originally published in 2014. Substantially updated and clinically reviewed in 2026 to reflect current evidence, guidelines, and urgent care practice. INTRODUCTION Ankle and foot injuries are one of the most common presentations in the urgent care setting, owing to the vulnerability of the ankle and foot joint complex. Severe injuries are not limited to fractures but can also include soft tissue—skin, ligaments, tendons, and muscles. Fortunately, the severity of the injury …
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When to Consider Idiopathic Normal Pressure Hydrocephalus in the Older Urgent Care Patient
Urgent Message: The features of idiopathic normal pressure hydrocephalus are easily attributed to normal aging, so the diagnosis is frequently missed. Clinicians should know when to suspect the syndrome, how to evaluate for it, and how to refer to a specialist for diagnosis confirmation and management. Keywords: idiopathic normal pressure hydrocephalus; gait disturbance; urinary incontinence; cognitive impairment; ventriculomegaly; older adults; urgent care Kenneth V. Iserson, MD, MBA, FACEP, FAAEM Abstract Idiopathic normal pressure hydrocephalus (iNPH) …
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Shingles Rates Declining, Likely Because of Vaccination
The childhood varicella vaccine was introduced in the United States in 1995, so people born from that time on are the first group to reach adulthood with the vaccine’s protection against chickenpox. Additionally, those vaccinated against chickenpox carry a lower risk of later developing shingles caused by the reactivation of the varicella-zoster virus. A new study of more than 85 million U.S. adults found substantial differences in shingles diagnoses across birth cohorts, with the sharpest …
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22-Year-Old With Growing, Painful Lump on Back of Knee
A 22-year-old male presents to urgent care complaining of a painful lump on the back of his left knee that developed roughly 3 years prior. It has gradually grown in size and discomfort since then. The lump has been growing more quickly and becoming more painful over the last month, to the point where it is difficult to play sports and exercise. Physical examination reveals normal vital signs and full range of motion and strength …
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Psychogenic Nonepileptic Seizures in the Urgent Care Setting: A Case Report
Urgent Message: Accurately identifying psychogenic nonepileptic seizures in the acute care setting helps avoid dangerous and costly medical interventions, such as aggressive antiepileptic drug treatment. Jacob Welch, OMS-4; Logan Hurm, OMS-4; Akul Mitra, OMS-4; Cameron Shoemaker, PGY-2; Michael B. Weinstock, MD Keywords: psychogenic nonepileptic seizures; functional seizure; functional neurological disorder Abstract Introduction: Psychogenic nonepileptic seizures (PNES) mimic epilepsy but lack epileptiform electrical brain activity. In the urgent care setting, prioritizing rapid stabilization often leads to …
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Factors Associated With the Use of an Online Appointment Tool in Urgent Care Centers
Urgent Message: Significant differences in the use of an online appointment tool based on age, race, insurance type, and urgent care setting underline the need for targeted strategies to address differences in adoption across patient groups. E. Melinda Mahabee-Gittens, MD, PhD; Parth Divekar, MS; Lara Stone, MA; David Schnadower, MD, MPH; Sinem Toraman Turk, PhD Keywords: online appointment scheduling; pediatric urgent care; virtual queueing; digital health; healthcare access; health disparities Abstract Aim: To keep up …
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Urgent Care Refers 1 Patient in 50 to the ED
Urgent Message: Urgent care sends roughly 1 patient in 50 to the emergency department. Most of those referrals involve symptoms that call for imaging, laboratory testing, or monitoring that the clinic cannot provide. Some are emergencies identified during the visit for an ordinary complaint. Keywords: emergency department referral; emergency department transfer; urgent care referral patterns; practice variation; clinical documentation; urgent care operations Alan A. Ayers, MBA, MAcc Consider a scenario in which a patient writes …
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Urgent Care Evaluation and Management of Acromioclavicular Separation
Urgent Message: Urgent care management of acromioclavicular joint separation consists of patient education on immobilization and pain management with consideration for emergency department referral when red flags are present. Jerome Walsh, BS; Clinton Hartz, MD; Michael B. Weinstock, MD Keywords: acromioclavicular joint separation; ac joint injury; shoulder trauma; rockwood classification; shoulder injury; urgent care Questions for the Clinician at the Bedside Editor’s Note: While the images presented here are authentic, the patient case scenarios are …
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