On ED Visits, Corticosteroids and COPD, Intranasal Steroid in Allergic Rhinitis, Intussusception in Children Under 5, Urinary Antigen Testing, and Emergency Contraception Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Emergency Department Visits on the Rise Key point: ED use in the U.S. is up dramatically; these stats …
Read MoreClinical Challenge 2: October, 2010
The patient is a 54-year-old woman who presents with a three-day history of constipation. She denies any vomiting, and you note no abdominal distension. She is passing small amounts of gas. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the page.
Read MoreAbstracts in Urgent Care: October, 2010
On Imaging Head Injuries, Routine Cellulitis, Alteplase and Ischemic Stroke, Head Lice, Steroids for Pharyngitis, and Brain Injury in Children Nahum Kovalski, BSc, MDCM Each month, Dr. Nahum Kovalski reviews a handful of abstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Diagnostic Imaging Rates for Head Injury in the ED and States’ Medical Malpractice Tort Reforms Key point: The authors found …
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14-year-old boy with lower back pain stemming from fall
The patient is a 14-year-old boy who presents with low back pain after falling from “a high height” and landing on his feet. Exam is normal except for tenderness in the mid-lumbar region. View the image taken and consider what your diagnosis and next steps would be.
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17-year-old boy injures knee during a fall
The patient is a 17-year-old boy who experienced a blow to the right knee in the course of a fall. He complains of pain over the knee and is unable bear weight on the leg. On examination, you find local swelling. View the image taken and consider what your diagnosis and next steps would be.
Read MoreClinical Challenge 2: September 2010
The patient is a 32-year-old man who presents after experiencing a blow to the face while falling from a bicycle. The patient complains of tenderness over the front of his face. Neurological exam is normal. You note that his neck is supple. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge: September, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 62-year-old who presents with a primary complaint of right shoulder pain that developed over time. The patient denies any trauma. The patient is …
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20-year-old female with knee pain after fall
The patient is a 20-year-old female who presents with pain one day after falling and experiencing a blow to the knee. Examination reveals no significant findings beyond mild local tenderness. She is able to bear weight fully on both legs. View the image and consider what your diagnosis and next steps would be.
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16-year-old male experiencing chest and throat pain
The patient is a 16-year-old male who presents with difficulty breathing, pain in his throat, difficulty swallowing, and pleuritic chest pain. He reports that the symptoms began “a couple of hours” earlier. There is no history of trauma, choking, or recent dental procedure. The patient looks well, and is quiet and not toxic. Pulse is 75, O2sat 94; there is no fever. Chest is normal, with bilateral air entry. Assessment is hindered by the patient’s …
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93-year-old female with a twisted ankle
The patient is a 93-year-old female who lost her balance and twisted her ankle. She presents with significant pain in the ankle and swelling over her lateral ankle, though she is able to bear weight. View the image and consider what your diagnosis and next steps would be.
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