Case A 78-year-old man presents to an urgent care center with bilateral knee pain that he has had for 1 week. The pain is worse in his right knee and is worse with ambulation. He says that he has not experienced any recent trauma, but he does note that he has been helping his son move into an apartment. He reports no fever, dizziness, chest pain, or shortness of breath. He has hypertension, for which …
Read MoreYoung Football Player with Sudden Chest Pain
Case A 20-year-old previously healthy man presents with sudden onset of substernal chest pressure after completing football practice. His chest pain is nonradiating, nonreproducible, and nonpositional. He does not have associated palpitations, dyspnea, or diaphoresis. He reports that he has not had recent upper respiratory tract infections or contact with ill people. He does not have a history of using alcohol, tobacco, or illicit drugs. He has no family history of sudden cardiac death or …
Read MorePain in the Hand After Punching a Wall
Case An 18-year-old man presents to an urgent care center with pain at the distal aspect of the metacarpal bone of the little finger. The pain began 2 hours earlier, after he punched a wall. He has pain with range of motion and a minimal amount of numbness in the finger. He reports that he has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreA Fall from a Roof by an Adult
Case A 29-year-old woman presents to an urgent care center after a fall from the roof of her house, where she was cleaning the gutters. She reports that her right heel began hurting intensely immediately after the fall and that the pain worsened in the time it took for a family member to get her to the center. She cannot bear weight on her right leg. She mentions that she is a runner who often takes part in …
Read MoreTen-Day Dry Cough in a 36-Year-Old Man
Case A 36-year-old man presents to an urgent care center with a dry cough that he has had for the preceding 10 days. He has mild dyspnea. He has no rhinorrhea, fever, chest pain, blood in the urine or stool, or lower-extremity pain or swelling. He has no history of previous illnesses. He smokes cigarettes, occasionally drinks alcohol, and has a remote history of intravenous drug use. View the image taken (Figure 1) and consider …
Read MoreClavicular Pain in a 23-Year-Old
Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …
Read MoreKnee Pain in an 8-Year-Old Boy
Case An 8-year-old boy presents to an urgent care center with left knee pain that he has had for 3 days. The pain is worse with walking, and his mother says that he has been limping and will not put full weight on the leg. He reports no trauma, fever, vomiting, or numbness. His mother reports that she has given him ibuprofen but that this has not relieved his pain. View the image taken (Figure …
Read MoreFoot Injury in a Weekend Warrior
A 46-year-old weekend warrior presents to an urgent care center 3 hours after injuring his right ankle and foot while playing basketball. He reports moderate to severe pain over the lateral side of the ankle and foot, which started after he jumped for a rebound and came down on the foot while it was in plantar flexion and inverted. However, he can walk. He reports no paresthesia or pain at the midfoot or proximal fibula, …
Read MoreHeel and Ankle Pain in an Adult After a Jump from a Second-Floor Window
A 38-year-old man presents to an urgent care center and reports pain in his right heel and ankle that he describes as severe enough that he cannot walk on the foot. He says that the pain began the previous evening when he landed on the group after jumping out of a second-floor window on a dare. He has some minimal paresthesia, but he has no fever, vomiting, head trauma, head or neck pain, or chest …
Read MoreHip Pain in an Adult After a Fall
A 67-year-old woman presents to an urgent care center after 12 hours of pain in her right hip that began after she slipped in her kitchen and fell onto that hip. She reports that the pain is constant and worsens with walking. She has not experienced numbness in the hip, and she reports no other injuries. She has not sustained any head trauma, and she has no head or neck pain. View the image taken …
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