Postoperative Complications in the Urgent Care Setting

Urgent message: Patients who have had recent surgical procedures may present to urgent care centers for reasons ranging from seeking reassurance to presentation of life-threatening complications. Tracey Quail Davidoff, MD Introduction Patients often experience complications—or, at least as often, fear they’re experiencing complications—after a surgical procedure. While the surgeon is often the best person for them to consult, this may not be possible for a variety of reasons. Outpatient surgical centers are opening almost at …

Tattoos and Piercings: What the Urgent Care Provider Needs to Know

Urgent message: Tattoos and piercings are becoming commonplace, but patients who experience complications with these forms of body art may present to urgent care centers, as access to dermatology and plastics specialists frequently requires a referral or extended wait periods. The urgent care provider should possess a working knowledge about how tattoos and piercings are performed, how to recognize the complications, and how to treat them appropriately. Tracey Quail Davidoff, MD TATTOOS Introduction The term …

The Red-Hot Joint

Urgent message: Septic arthritis can lead to significant morbidity if not treated in a timely manner. Bacteria within the synovial space can lead to rapid joint destruction and irreversible loss of function. When patients present to the urgent care center with a red, hot, swollen, painful joint, every attempt must be made to rule out this disease entity to prevent significant morbidity and mortality. Introduction Patients frequently present to urgent care with a red, swollen, …

Acute Severe Thigh Pain While Running

Urgent message: Summer brings increased participation in outdoor activities and sports in which patients are likely to sustain injury. Patients with thigh injuries, such as injury to the quadriceps and patellar tendon, may present to the urgent care center. Timely diagnosis is essential in preserving strength and function of the quadriceps complex. TRACEY QUAIL DAVIDOFF, MD Patients who run and jump are at risk for injuring their quadriceps complex. These activities are common in the …

Upper Gastrointestinal Disorders in Urgent Care, Part 2: Biliary Tract and Pancreatic Disease

Urgent message: Upper abdominal pain is a common presentation in urgent care practice. Narrowing the differential diagnosis is sometimes difficult. Understanding the pathophysiology of each disease is the key to making the correct diagnosis and providing the proper treatment. TRACEY Q. DAVIDOFF, MD Part 1 of this series focused on disorders of the stomach—gastritis and peptic ulcer disease—on the left side of the upper abdomen. This article focuses on the right side and center of …

Upper Gastrointestinal Disorders in Urgent Care, Part 1: Gastritis, Peptic Ulcer Disease, and Helicobacter pylori

Urgent message: Gastritis and peptic ulcer disease are a spectrum of diseases that can range from mild to serious; urgent care providers must be on the alert for these conditions. Early diagnosis and treatment, along with recommendations for follow-up care with appropriate specialists, can help prevent long-term sequelae. TRACEY Q. DAVIDOFF, MD Gastritis and peptic ulcer disease (PUD) represent a continuum along a path of inflammation of the gastric mucosa, from superficial irritation of the …

Boy with swollen foot

This image was taken on a 6-year-old male who was wrestling with his cousins when he developed severe pain in his right foot. There was bruising and swelling over the dorsum of the right foot. View the images taken (Figure 1) and consider what your diagnosis would be.

Woman with rash

This image was taken of a 44-year-old female who presented to the urgent care center with an itchy rash on her arms and legs that she has never had before. Four 4 days ago, she returned from a church retreat at a camp where she slept in a cabin in the woods. Most of the retreat was indoors. She is the only one with a rash and her husband, who slept in a different bed, …

Clinical Challenge: November, 2014

The Case This x-ray was taken on a 72-year-old man who presented to urgent care after falling off a step stool while trimming branches. He landed directly on his left shoulder and was unable to lift his arm over his head due to severe pain. He thought his shoulder was dislocated. View the image taken (Figure 1) and consider what your diagnosis would be.

Man with bruised hand

These x-rays were taken on a 47-year-old male who presented to an urgent care clinic 3 days after punching a wall. He had pain, massive swelling, and bruising at the base of the 3rd, 4th and 5th metacarpals of the right hand. View the images taken (Figure 1) and consider what your diagnosis would be.

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