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Cervical Fasciitis—An Unusual Cause of Neck Pain

Urgent message: Though neck pain is a common complaint among patients presenting to urgent care centers, cervical fasciitis is a relatively uncommon cause. Nonetheless, urgent care providers should consider it in the differential diagnosis for patients presenting with neck pain, even those who are afebrile. Mark Richman, MD, MPH; Brendan Appold, MS; and Jennie Soniega-Sherwood, MPH Case Presentation The patient is a 62-year-old-female with no significant past medical history who presented to a hospital-based urgent care center complaining of 1 week of worsening sharp, right-sided, nonradiating neck pain uncontrolled with acetaminophen …
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An Uncommon Clinical Presentation of Ovarian Torsion

Urgent message: Abdominal pain is an extremely common complaint in the urgent care setting. The differential diagnosis of abdominal pain is often a challenge, however, because many symptoms and signs are nonspecific. Ovarian torsion usually presents with sudden onset of severe, unilateral lower abdominal pain, associated with nausea and vomiting; however, in a small percentage of cases, the clinical course is prolonged, as the torsion can be intermittent. While failure to consider ovarian torsion in the differential diagnosis is not uncommon, given its relatively low occurrence, timely diagnosis is of …
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Cardiopulmonary Emergency Masquerading as Gastrointestinal Symptoms

Nihar B. Gala, MD Urgent message: The ability to distinguish between urgent and truly emergent conditions is an essential skill for all urgent care providers. That distinction is especially challenging when symptoms could indicate either a relatively benign diagnosis that is well within the purview of the urgent care setting or a more dire diagnosis better suited for a higher-acuity setting. Introduction “Familiar” symptoms such as vomiting, diarrhea, and abdominal pain could be due to a mild viral infection—or, as in this case, a potentially life-threatening emergency. The key to …
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A 38-Year-Old Man with Chest Pain

Urgent message: When a relatively young patient presents to urgent care with chest pain, there may or may not be a “typical” cause. Prompt evaluation and accurate assessment of risk factors are essential to efficient care and, often, the patient’s survival. Max Palatnik, MD Case Presentation A 35-year-old male presented at 21:59 with a chief complaint of chest pain; at 22:03, we noted the following: Temp: 98.9 Pulse: 103 Resp: 16 Syst: 122 Diast: 69 O2Sat: 99% History of Present Illness (22:47) (Verbatim) Pt. 38 year old male with a …
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Neck Rash on a 21-year-old Male

Urgent message: Acanthosis nigricans has a strong association with obesity and insulin resistance. Assessment involves a thorough physical exam to differentiate from other dermatosis, as well as full workup for insulin resistance. Early diagnosis in the urgent care setting, and treatment, will improve the appearance of acanthosis nigricans, but also the patient’s overall morbidity. Shailendra Saxena, MD, PhD and Bao Chau Nguyen, BS Introduction A 21-year-old Caucasian male presented for a circumferential hyperpigmented rash around the neck that began several months ago. History Past medical history was significant for morbid …
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