Journal of Urgent Care Medicine

21-Year-Old Male With Cough and Night Sweats

A 21-year-old male with no significant past medical history presents to urgent care with a 3-week history of progressive cough, night sweats, dyspnea, and chest discomfort. He denies sore throat, rhinorrhea, sinus congestion, hemoptysis, weight loss, wheezing, tobacco use, or illicit drug use. On examination, vital signs are within normal limits. The patient appears well and not in acute distress. Lung auscultation was clear bilaterally, and the remainder of the initial physical exam is unremarkable. …

60-Year-Old With Palpitations

A 60-year-old female presents to urgent care with palpitations that started abruptly 1 hour prior to arrival. She denies recent illness or cardiac history. An ECG is ordered. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 16-Year-Old Male With Rash to Legs, Altered Mental Status and Fever

A 16-year-old male presents to urgent care accompanied by his father due to acute onset of fever, abdominal pain, fatigue, altered mental status, and a lower-extremity rash. Symptoms began earlier the same day. The patient denies recent upper respiratory symptoms, medication use, travel, or trauma. On physical examination, he appears acutely ill and febrile to 103.1°F (39.5°C). Neurologic assessment reveals altered mental status. Dermatologic exam shows retiform, violaceous purpuric plaques with maroon borders on both …

24-Year-Old Male Hand Pain After a Golf Game

A 24-year-old male patient presents to urgent care with right wrist pain that started while playing golf 2 days ago. The patient recalls swinging the club and hitting the ground rather than the ball, felt a sharp pain in his hand which has been constant since the incident. He has not tried any treatments at home. The provider notes increased pain when the patient flexes his hand, along with a weakened grip compared to the …

60-Year-Old With 2 Weeks of Dyspnea

A 60-year-old male presents to urgent care with progressive dyspnea for 2 weeks associated with lower extremity edema. The patient is afebrile and slightly tachypneic with rales at the bilateral bases. An ECG is obtained. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

28-Year-Old Female with Left Lower Quadrant Pain

A 28-year-old female presents to urgent care with mild left lower quadrant (LLQ) abdominal pain that began earlier in the day. The discomfort is dull, intermittent, and non-radiating. She denies vaginal bleeding, fever, nausea, vomiting, or urinary symptoms. Her last menstrual period was approximately 2 months ago, although she reports a history of irregular cycles. She appears well and is hemodynamically stable. An abdominal exam reveals mild LLQ tenderness without rebound or guarding. A pelvic …

75-Year-Old Male with Facial Lesion

A 75-year-old male presents to the walk-in clinic with the chief complaint of an asymptomatic rash on the left temple of his face that developed over the past 2 months. On examination, a shiny deep red papule is visible with scaly macules (actinic keratoses) surrounding. The patient is on rituximab for chronic lymphocytic leukemia (CLL). View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …

11-year-old With Heel Pain While Running

An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past. Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be …

80-Year-Old With Substernal Chest Pain

An 80-year-old male with hypertension and hyperlipidemia presents to urgent care for 1 day of sharp, substernal chest pain radiating to his right arm with associated shortness of breath and diaphoresis. His wife notes that he is often nonadherent with his medications. An ECG is ordered. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 42-year-old Female with a Widespread Scaly Rash

A 42-year-old woman with widespread scaly lesions presents to urgent care. On exam, the provider noted superficial crusts and exfoliative plaques seen on the face, neck, and chest. The patient reported that the lesions were painful, but she had no systemic symptoms and felt fine otherwise. The rash emerged a couple of months prior. The patient had no recent history of travel or infections and was not currently on any medications. The urgent care took …

Login to JUCM