Journal of Urgent Care Medicine

Clinical Challenge: February, 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 17-year-old male who fell and experienced a blow to the right knee. On examination, you not local swelling. The patient complains of pain …

Clinical Challenge 2: January 2010

The patient is a 20- year- old female who presents with pain one day after experiencing a blow to the knee during a fall. On exam, you reveal no significant findings beyond mild local tenderness. She is able to bear weight fully on both legs. 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.

Insights In Images

The patient is a 2 ½-year-old child whose parents report recurrent episodes of abdominal pain without vomiting or diarrhea. On exam, you note fullness of the abdomen. 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.

73-year-old woman with foreign body lodged in hand after fall

The patient is a 73-year-old woman who presents with a foreign body (a piece of wood, specifically) sticking out of a scratch on her hand. She reports that she fell in her yard. On examination, you discover that she also has local pain and swelling of the left wrist. View the x-ray taken and consider what your diagnosis and next steps would be.

Clinical Challenge: December, 2009

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 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 …

23-year-old male complains of heel pain since slipping down steps

The patient is a 23-year-old male who presents with a complaint of pain in the heel area after slipping down four steps. He is limping but able to bear weight. On exam, you note local tenderness and swelling over the area of the Achilles tendon. Other findings are unremarkable. View the x-ray taken and consider what your diagnosis and next steps would be.

55-year-old female experienced blow to back from fall

The patient is a 55-year-old female who experienced a blow to the back when she fell while riding a bus. She complains of pain in her neck, shoulder, and back. On examination, you find that her vitals are stable and she has no significant past medical history. View the x-ray taken and consider what your diagnosis and next steps would be.

Treatment of Pediatric Community-acquired Pneumonia in an Urgent Care Center

Urgent message: Although diagnosis of pediatric community-acquired pneumonia is not always straightforward, most cases can be diagnosed adequately by non-pediatricians and treated in the urgent care center, thereby reducing hospitalization for this condition. By Deena R. Zimmerman, MD, MPH, IBCLC, Scott Fields, MD, Nahum Kovalski, BSc, MDCM Introduction Pediatric community-acquired pneumonia (CAP) is a common illness. Estimates are that the annual incidence of pneumonia per 1,000 children in North America ranges from 30 to 45 cases …

Clinical Challenge: November, 2009

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 19-year-old male who complains of pain after receiving a blow to the shoulder. Range of motion is limited due to pain. The patient …

82-year-old man slips and takes a blow to his shoulder

The patient is an 82-year-old man who slipped on the street, experiencing a blow to his right shoulder. He has significant local swelling in the injured shoulder (specifically, over the acromioclavicular joint), as well as significantly limited range of motion. His distal pulses are normal. View the x-ray taken and consider what your diagnosis and next steps would be.

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