In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with.

If you would live to submit a case for consideration, please w-mail the relevant materials and presenting information to [email protected]

Figure 1.

The patient is a 14-year-old boy who presents with low back pain after failing from “a high height” and landing on his feet.

Exam is normal except for tenderness in the mid-lumbar region.

View the image taken (Figure 1) and consider what your diagnosis and next steps would be.
Resolution of the case is described on the next page.

Clinical Challenge: March, 2010

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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