A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A mother brings her 13-year-old daughter to your urgent care center with a complaint of fever, chills, dry cough, and myalgia for 3 days. On exam, the patient is febrile (101°F). In addition, there is conjunctival injection and blanching erythematous patches on the face and neck. The mother mentions that the family returned from a trip to Brazil 10 days prior. While traveling they ate local food, drank local (unfiltered) water, sustained a few mosquito …

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A 14-Year-Old Wrestler with Shoulder Pain After a Match

A 14-Year-Old Wrestler with Shoulder Pain After a Match

The patient is a 14-year-old boy who reports to urgent care with left shoulder pain after a junior high wrestling match. He is vague about the precise location and possible mechanism of injury but through the physical exam you notice a prominence of the sternoclavicular joint and pain radiating along the clavicle. View the x-ray taken and consider what your diagnosis and next steps would be.

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A 27-Year-Old Male with Chest Pain and No Reported Medical History

Chamber Abnormalities: Pathologic or Not? A 27-year-old male with no reported medical history presents with chest pain. He relays  several weeks of intermittent symptoms which started after lifting heavy boxes. The pain is sharp, located in the mid-chest and is otherwise non-tearing, non-pleuritic, non-positional and not associated with exertion. On examination, the patient is in no acute distress, and appears lean without cachexia or wasting. The pain is reproduced with shoulder extension. It resolves with …

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A 68-Year-Old Woman with a Rash of Several Weeks’ Duration

A 68-Year-Old Woman with a Rash of Several Weeks’ Duration

The patient is a 68-year-old woman who presents with a rash she says developed on her trunk over a span of several weeks. On examination, there were multiple confluent, orange-red plaques on the trunk and arms with “islands of sparing” within them. The rash had a primarily truncal distribution and was pruritic. She was feeling well otherwise. View the image and consider what your next steps and diagnosis would be. Resolution of the case is …

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A 36-Year-Old Male with Sudden-Onset Substernal Chest Pain

A 36-Year-Old Male with Sudden-Onset Substernal Chest Pain

The patient is a 36-year-old male with a history of tobacco and alcohol use who presents to urgent care with sudden-onset substernal chest pain and shortness of breath that began 1 hour prior to arrival.               View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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A 43-Year-Old Man with a Painful, Purulent Finger

A 43-Year-Old Man with a Painful, Purulent Finger

The patient is a 43-year-old male who presents with a painful collection of pus near his fingernail. He reported that it had developed over the past day. On examination, a large, yellow-green superficial pus collection was seen at the proximal nail fold with surrounding erythema and edema. The patient mentioned that he had a home renovation business and that it was common for him to experience mild injuries such as splinters on his hands. The …

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