Journal of Urgent Care Medicine

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 …

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 …

Occult Presentation of Necrotizing Fasciitis With Subtle Clinical Findings: A Case Report

Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …

Postpartum Presentations: When Risk Arises After Delivery – Shortness of Breath

Urgent Message: Shortness of breath presentations for postpartum patients in urgent care should prompt consideration of venous thromboembolism or peripartum cardiomyopathy, or more benign conditions like deconditioning, bronchitis, or anxiety. Alexa Bailey, DO; Lauren Kostandaras, DO; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO. Key Words: Shortness Of Breath, Postpartum, Venous Thromboembolism, VTE, Deep Vein Thrombosis, DVT, Pulmonary Embolism, PE, Peripartum Cardiomyopathy Editor’s Note: The patient case scenario is hypothetical. Abstract Background: The postpartum …

Ruptured Baker Cyst is an Uncommon Complication of a Common Diagnosis: A Case Report

Urgent Message: Rupture of a Baker cyst is a rare complication and may manifest with the classic crescent sign of ecchymosis and swelling over the medial malleolus. Given the similarities in presentation to acute deep vein thrombosis, it is essential for urgent care clinicians to be able to differentiate between these diagnoses. Caroline S. Mifsud, DO, MS; Jennifer Ganzhorn, MD; Michael B. Weinstock, MD; Gregory M. Garrison, MD, MS, FAAFP; Elizabeth Westby, MD Keywords: Baker …

Postpartum Presentations: When Risk Arises After Delivery – Vaginal Bleeding and Discharge

Urgent Message: Postpartum vaginal bleeding and discharge have a broad range of etiologies ranging from benign and self-limited to life-threatening. As postpartum patients may present to urgent care centers with concerns for bleeding or discharge, it is important for clinicians to have an understanding of the unique differential diagnosis for causes of hemorrhage in this population. Alexa Bailey, BS; Lauren Kostandaras, BS; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO. Citation: Bailey A, Kostandaras …

Postpartum Presentations: When Risk Arises After Delivery – Headache

Urgent Message: Both common and serious postpartum conditions may present in urgent care. Headache presentations should prompt consideration for possible postpartum preeclampsia, cerebral venous thrombosis, or post-dural puncture headache. Alexa Bailey, BS; Lauren Kostandaras, BS; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO Citation: Bailey A, Kostandaras L, Poorman H, Weinstock M, Neal C. Postpartum Presentations: When Risk Arises after Delivery – Headache. J Urgent Care Med. 2025; 19(6): 23-30 Key Words: headache, postpartum, …

Urgent Care Considerations for the Patient with Suspected Rib Fracture

Urgent Message: Rib fractures most commonly occur after blunt chest injury. Consider serious associated injuries such as pneumothorax, hemothorax, and pulmonary contusion when assessing patients with suspected rib fractures. Ensuring appropriate analgesia is critical for reducing the risk of complications. Dustin M. Nelson, BS; Shering Torres, MAS, MD; Michael Weinstock, MD Citation: Nelson DM, Torres S, Weinstock M. Urgent Care Considerations for the Patient with Suspected Rib Fracture. J Urgent Care Med. 2025; 19(4): 13-21 …

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

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