Clinical Feature Articles

The patient is a 51-year-old woman who presented to urgent care complaining of a rash, pruritus, myalgias, and muscle weakness. The rash was an erythematous blanching patch spread across her chest in a V shape. She had also noticed that her fingernail folds were red and swollen. The patient can’t recall when she first noticed her symptoms, but reports that they’ve started affected her everyday life (such as having difficulty rising from a chair) within “the past couple of weeks” View the image taken and consider what your diagnosis and …
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Urgent message: Though ear pain is often due to otitis media or externa, it is important to include other diagnoses, some of which could be life-threatening, “can’t miss” causes. Introduction Patient complaints of ear pain (otalgia) are seen frequently in the urgent care setting. It can be frustrating for patients and providers when a patient’s ear pain has no obvious cause. Differential diagnoses include several primary and secondary causes of otalgia. (See Table 1.) Lab values or radiological films are rarely helpful; the best diagnostic tool for ear-pain complaints is …
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David Mathison, MD, MBA   Thirty years ago, there was widespread concern that specialty medicine was “a problem.” Consumers were self-selecting specialty (vs primary) care for routine ailments, thus driving up the cost of healthcare. Without restrictions, consumers could choose neurologists for headaches, orthopedists for ankle sprains, and dermatologists for acne—all very appropriate with complexity, but unnecessary and costly for routine problems. Hence came the dawn of managed care armed with gatekeepers, referral requirements, and preferred networks to limit the use of specialty care and maximize cost containment by expanding …
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Urgent message: Care of the pregnant patient in urgent care can be complex, as every test or treatment needs to take into account both the mother and her unborn child. Conditions which would be considered benign and self-limited in healthy patients take on a different level of concern, and must be managed differently, in the pregnant patient. James Hicks, MD INTRODUCTION There appears to be a wide variety of comfort levels within any particular urgent care center regarding pregnancy. While most obstetrical practices encourage the patient to call their obstetrician …
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Urgent message: Urgent care is often the first stop for patients experiencing acute eye complaints, including conjunctivitis. The capability to accurately distinguish between infectious conjunctivitis of a viral nature vs that of a bacterial nature is essential to administering appropriate treatment and avoiding inappropriate use of antibiotics.Isabelle Dortonne, MD, Patrizia Colmenares, OD, Trevor Lyford, BA, OSC, and John Sheppard, MD, MMScINTRODUCTIONThe vast majority of acute conjunctivitis is viral in nature, with 65% to 90% due to adenoviruses.1 Despite this, a study by University of Michigan’s Kellogg Eye Center found that …
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