The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child was asleep. The abdomen was easily palpable and soft. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described below.
Read MoreClinical Challenge 2: May 2007
The patient is a 13-year-old male who presented to urgent care after taking a fall while running; he landed on his outstretched left hand. Upon examination, you find tenderness in the snuff box and observe swelling around the wrist. View the x-ray 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: May, 2007
The patient is a 2½-year-old female who presented after falling, unobserved, from an unknown height with tenderness and swelling around the elbow. Neurovascular exam was normal. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Resulotion The correct diagnosis is a supracondylar fracture; note the loss of the normal angle at the distal humerus. The injury was managed …
Read MoreClinical Challenge 2: April, 2007
The patient is a 25-year-old male who presented to urgent care after falling from a height of two stories, landing flat on his feet. He is able to ambulate, though only with pain. In addition, he complains of back pain. He is generally healthy, and no neurological deficit was found. View the x-ray taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge: April, 2007
The patient is a 3-year-old female who presented after a fall while running and complaining of pain over the foot. There was minimal local tenderness over the foot and minimal limp, but no other remarkable findings. View the x-ray taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge 2: March, 2007
The patient is a healthy 37-year-old who reports falling on his hand, with his thumb outstretched. Upon examination, you find local mild swelling and tenderness and decreased range of motion of the thumb. There is no snuffbox tenderness, however. View the x-rays taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.
Read MoreAbstracts in Urgent Care October 2006
Each month, Dr. Nahum Kovalski will review a handful ofabstracts from, or relevant to, urgent care practices and practitioners. For the full reports, go to the source cited under each title. Dexamethasone Has Advantage Over Prednisolone in Children with Croup Citation: Sparrow A, Geelhoed G. Arch Dis Child. 2006;91:580-583. Children with croup who are treated with prednisolone are more likely than those treated with dexamethasone to return for additional medical care, researchers in Australia reported …
Read MoreOn Croup, Wet Sutures, Fast Tracking the ED, Acetaminophen and ALT, and Stone Formation
NAHUM KOVALSKI, BSc, MDCM
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