Practice Management
Case A 38-year-old female patient presents with acute shoulder pain following a fall on an outstretched arm during a spring skiing vacation. There is a normal appearance to the shoulder, but significant pain even with minimal attempts at range of motion. The clavicle and elbow are nontender. Neurovascular status is intact. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
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Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
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A mother brings her 3-year-old daughter to your urgent care center, concerned about a rash that developed at the same time the girl started having a runny nose and low-grade fever, and became slightly lethargic. Now her cheeks are bright red, and she has a blanching macular rash that’s spread slowly from her extremities to her trunk. View the image and consider your next steps, along with possible diagnoses.
Read MoreCase This 42-year-old woman presents to your urgent care center with a 2-hour history intermittent dizziness and vomiting. She denies diarrhea or exposure to ill persons. Further history reveals that she has recently had some epigastric discomfort. In the exam room, she is alert and oriented. She seems comfortable, in fact. In addition, you find: Lungs: Minimal bilateral symmetric wheezing Cardiovascular: Regular rate and rhythm without murmur, rub, or gallop Abdomen: Soft and nontender without …
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The patient is a 37-year-old man who reports a two-day history of chest pain. It worsens with exertion, and when he lays back; it improves when he’s sitting or leaning forward. He denies any diaphoresis, radiation, or back pain. No pleuritic aspect. During the exam, he is alert and oriented, and in no distress. In addition, you find: Lungs: Clear to auscultation bilaterally Cardiovascular: Regular rate and rhythm without murmur, rub, or gallop Abdomen: Soft …
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A 48-year-old woman presents with lower sacral and coccyx pain one day after a fall in which she says she simply “missed” the edge of a chair and landed on the floor at a party. View the images taken and consider your next steps, along with possible diagnoses.
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Case A 28-year-old woman presents to urgent care with elbow pain and swelling following a mechanical fall. She reports the pain is worse with range of motion. There is no shoulder or wrist pain, and no paresthesias. Exam confirms pain with palpation and decreased range of motion. The radial pulse is 2+; sensation distal to the elbow is grossly intact. The patient is afebrile, has a pulse of 104, respirations 20, and BP 124/80. View …
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A 47-year-old male presents to your urgent care center with an exacerbation of chronic hip pain. The patient offers little by way of explanation; he reports he’s felt discomfort in his right hip “for years,” but that it’s grown worse recently. View the images taken and consider your next steps, along with possible diagnoses.
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Case A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.” Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, …
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A 21-year-old male presents to your urgent care center complaining of back pain after falling from a ladder. He is unclear about the exact point of impact, but the pain increases with attempts to bend or twist. Examination reveals he has decreased range of motion. View the image taken (Figure 1) and consider your next steps, along with possible diagnoses.
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