Post Sports Injury Burn Due to Inappropriate Use of Cryotherapy

Post Sports Injury Burn Due to Inappropriate Use of Cryotherapy

Urgent message: PRICE (protection, rest, ice, compression and elevation) treatment is often advised to patients as part of sports soft tissue injuries; however, incorrect use of cryotherapy may lead to complications. Amitesh Kumar, MD Introduction Cryotherapy involves application of ice on acute soft tissue injuries in the form of ice cubes, ice packs, ice towels, ice massage, frozen gel packs, ethyl chloride, and other chemical devices. The goal is temperature reduction of 10-15⁰ C1 to …

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A 32-Year-Old Male with Unsteady Gait

A 32-Year-Old Male with Unsteady Gait

Urgent message: Early diagnosis and management of multiple sclerosis are crucial for long-term prognosis. Urgent care providers must be vigilant with proper history taking and thorough physical examination when looking for signs and symptoms of early MS. Waqas Memon, MD, Zonaira Shabbir, OMS IV, and Muhammad Akhtar, MD, FACP Introduction In the early course of multiple sclerosis (MS), the initial symptoms are nonspecific and intermittent, which makes the diagnosis challenging.1 Focusing on common symptoms and …

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Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Urgent message: Life-threatening degrees of rhabdomyolysis can be seen in young, healthy patients with stable presentation and nearly normal examination findings.   John Shufeldt, MD, JD, MBA, FACEP and Zana Alattar, MS3   Introduction This case demonstrates the importance of considering and ruling out rhabdomyolysis in patients with myalgia. We describe a case illustrating the management and work-up of myalgia in a young, healthy individual to identify the underlying cause. As with many illnesses, the …

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Leg Pain in a 34-Year-Old Man

Leg Pain in a 34-Year-Old Man

Urgent message: The ability to differentiate deep vein thrombosis from other diagnoses such as cellulitis is important in choosing the correct treatment option. Jeff Heimiller, MD  Case Presentation A 34-year-old male presented with a 1-week of right calf pain that was exacerbated by palpation and walking. He was unable to see his primary care physician that day, so he went to urgent care for evaluation. The patient also reported a sensation of shortness of breath …

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Cervical Facetitis—An Unusual Cause of Neck Pain

Cervical Facetitis—An Unusual Cause of Neck Pain

Urgent message: Though neck pain is a common complaint among patients presenting to urgent care centers, cervical facetitis 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 …

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An Uncommon Clinical Presentation of Ovarian Torsion

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 …

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Cardiopulmonary Emergency Masquerading as Gastrointestinal Symptoms

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 …

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A 38-Year-Old Man with Chest Pain

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 …

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Neck Rash on a 21-year-old Male

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 …

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A 5-Month-Old with Symptoms Beyond the Presenting Complaint

A 5-Month-Old with Symptoms Beyond the Presenting Complaint

Urgent message: Treating preverbal children can be challenging under every-day circumstances for pediatricians who know the child and the family. Urgent care providers who may not have the benefit of that history must be especially vigilant for all available signs and symptoms to make diagnoses based on the full scope of the presentation. Michael Weinstock, MD Case Presentation (Please note: The Case Presentation is drawn directly from the treating physician’s notes, without editing or correction, …

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