Journal of Urgent Care Medicine

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.

Evaluation and Management of Pain (Part 1): Acute Pain

Urgent message: Urgent care providers have a clinical, legal, and moral obligation to provide appropriate treatment for patients with pain. The first article in a two-part series addresses strategies for managing acute pain. TRACEY Q. DAVIDOFF, MD The interpretation of pain by patients is very subjective and not easily measured. That makes management of pain in the urgent care setting difficult. Current pain scales are often inaccurate or not truly reflective of a patient’s real …

The Simplest Explanation is Often the Best

Urgent message: Emergency Physicians are trained to rule out the most dangerous, life-threatening diagnosis first. Rarely, this can lead to missing the forest for the trees. Author: Tracey Quail Davidoff, MD Author Information: Dr. Davidoff is an urgent care physician at Accelcare Medical Urgent Care and Urgent Care by Lifetime Health in Rochester, New York. Case Presentation A 23-year-old male graduate student calls the urgent care center asking if he can be seen for dizziness …

Closed Hand Injuries

Urgent message: Even a seemingly minor hand injury can result in lifelong disability if evaluation and treatment are incorrect. TRACEY QUAIL DAVIDOFF, MD Introduction The hand is a vital part of human anatomy allowing us to interact with our environment in nearly infinite ways. The functional aspects of the hand are a direct extension of the brain, allowing us to initially make stone tools, play musical instruments, make intricate crafts, type, communicate, and appreciate our …