Journal of Urgent Care Medicine

When Bell Palsy Is Actually a Stroke: A Case Report

Urgent Message: While Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis, it is important for urgent care clinicians to be able to quickly differentiate it from other more serious diagnoses. Keywords: facial palsy; stroke mimic; Bell palsy; central facial weakness; peripheral facial palsy; urgent care evaluation Luke Wisniewski, OMS3; Finley Kocher, OMS3; Muhammad Akhtar, MD Abstract Introduction: Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis …

Progressive Ankle Pain in a 12-Year-Old Male: A Case Report of Osteomyelitis

Urgent Message: While most pediatric musculoskeletal complaints are usually benign and self-limited, the urgent care clinician must consider more serious underlying causes of pain in the differential diagnosis. Keywords: pediatric osteomyelitis; atraumatic ankle pain; limping child; bone infection; ESR; CRP; MRI diagnosis Erin Loo, PA-C, MHA, FCUCM Abstract Introduction: Pediatric patients commonly present to urgent care (UC) with musculoskeletal complaints. However, a wide differential should be considered, including musculoskeletal injury, synovitis, autoimmune conditions, cellulitis, avascular …

Management of Acute Opioid Withdrawal in a Patient With an Unknown Prescribing History: A Case Report

Urgent Message: Opioid prescribing in urgent care can present difficulties, particularly in patients with an unclear prescription history where added caution is needed. There are a number of ways to reduce the risks associated with opioid prescribing and to initiate the treatment of opioid withdrawal in the urgent care setting. Jacob Mather, BSc MBChB Key Words: Addiction, Opioid Withdrawal, Prescribing, Urgent Care Abstract Introduction: We report a complex case of a 37-year-old woman presenting to …

Chronic Calf Pain and Limp: A Case Report of Pediatric Slipped Capital Femoral Epiphysis

Urgent Message: Pediatric patients frequently present to urgent care with musculoskeletal complaints, but clinicians must remain aware of the less common surgical and medical emergencies that can present with these symptoms. Key Words: Slipped Capital Femoral Epiphysis; Pediatric Limp; Antalgic Gait; Obesity; Urgent Care Diagnosis Abstract Clinical Presentation: A 13-year-old male presented to a pediatric urgent care with the chief complaint of left calf pain for a month that had acutely worsened over the past …

STEMI With Musculoskeletal Chest Pain: A Case Report

Urgent Message: Reproducible chest wall pain is often considered a symptom that indicates a musculoskeletal diagnosis. However, it should not be used as the sole criterion for ruling out acute coronary syndrome, especially in high-risk populations. Key Words: STEMI; Reproducible Chest Pain; Atypical ACS; Urgent Care Evaluation Abstract Introduction: Chest pain remains a leading cause of emergency department (ED) visits, and its differential encompasses both life-threatening and benign conditions. In the United States, the lifetime …

Worsening Otitis Media Despite Correct Treatment: A Case Report of Pediatric Leukemia

Urgent Message: Clinical worsening of typically treatable infections should trigger clinicians to dig deeper for possible underlying, undiagnosed conditions. Key Words: Pediatric Leukemia; Otitis-Conjunctivitis Syndrome; Persistent Infection; Urgent Care Diagnosis Abstract Introduction: Clinical worsening of typically treatable infections is a common initial presentation for pediatric patients with developing underlying oncologic conditions such as leukemia. Due to the gradual development of these conditions, patients may come to urgent care (UC) with varied and multiple presentations, which …

A Rare Cardiopulmonary Debut of Systemic Lupus Erythematosus: A Pediatric Case Report

Urgent Message: In adolescents presenting with persistent chest pain and systemic symptoms, clinicians should maintain a high index of suspicion for autoimmune etiologies such as systemic lupus erythematosus causing pericardial and pleural effusions. Asra Usmani, MBBS, MD; Ali Baidoun, MD; Aaron Mahoney, DO; Megan Sikkema, DO Key Words: Pericardial Effusion, Pleural Effusion, Systemic Lupus Erythematosus, Chest Pain, Adolescent Abstract Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can affect multiple organ systems. …

Back Pain From Vertebral Metastases in Prostate Cancer: A Case Report

Urgent Message: Persistent, non-mechanical back pain should raise suspicion for non-muscular causes, and in this case, such pain in an older man was related to a diagnosis of metastatic prostate cancer with bone involvement. Rimsha Afzal, MA; Gregory M. Thompson, MD Key Words: Vertebral Metastases; Metastatic Prostate Cancer; Urgent Care Diagnosis Abstract Introduction: Back pain is a common presentation in the urgent care center. While the majority of diagnoses are self-resolving and of a musculoskeletal …

Severe Iron Deficiency Anemia Presenting with Fever and Gastrointestinal Complaints: A Pediatric Case Report

Urgent Message: While the evaluation of a chief complaint is a priority in urgent care, recognition of chronic disease progression is also critical. Eliana H. Kim, DO; Aaron J. Maki, MD, PhD Key Words: Anemia, Iron Deficiency, Down Syndrome, Trisomy 21, Transfusion, Strep Throat, Case Report Abstract Introduction: Often the chief complaint is the primary focus of urgent care visits. However, it is important to consider other aspects of the patient’s health, especially in pediatric …

High-Pressure Paint Gun Finger Injury: A Case Report

Urgent Message: While the initial clinical presentation of a high-pressure paint gun injury may not elicit concern, it is truly high-risk and requires emergent recognition and surgical intervention. Key words: High-Pressure Injection Injury, Paint Gun Injury, Finger Trauma, Pyogenic Tenosynovitis, Occupational Injury, Subcutaneous Paint Infiltration, Finger Compartment Syndrome, Finger Emergency Abstract Introduction: High-pressure injection injuries of the hand are rare but represent true surgical emergencies. Despite often appearing deceptively mild on initial presentation, these injuries …

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