Case The patient is an 8-year-old boy with pain in the right foot for the last several hours. He refuses to walk on the foot. There is no reported injury. On physical exam, you find there is a normal appearance to the foot (no erythema, swelling). However, there is pain with palpation over the plantar aspect of the mid aspect of the right foot. View the image taken (Figure 1) and consider what your diagnosis …
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Irregular Skin Patch on a 16-Year-Old Boy
A 16-year-old presents with an irregular patch of skin on his chest, reporting that it has become increasingly hyperpigmented over the past year. He also says the same area has had in increase in hair growth in recent months View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreLateral Humeral Condyle Fracture
Case A 14-year-old boy presents to urgent care complaining of lateral right elbow pain that began after a fall on the playground yesterday, in which he landed on his outstretched hand. He has no significant medical or surgical history. The elbow pain is worse with range of motion. He denies any wrist or shoulder pain, and there is no head trauma. There are no paresthesias to the hand or arm. View the images taken (Figures …
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Pain and Changes in Appearance in a Child’s Eye
Parents bring their 2-year-old boy to an urgent care center after noticing that his right pupil looks white, and that the eye is excessively teary and looks bloodshot. They report that they boy has also complained that it hurts on occasion. View the image taken (Figure 1) and consider what your diagnosis would be
Read MoreDry Cough in a 19-Year-Old Male
Case A 19-year-old man presents to urgent care with a 5-day history of a dry cough. He says he has “felt warm” but didn’t think to check his temperature. He also complains that he has been weak, with a decreased appetite. He notes that his girlfriend had an upper respiratory infection a couple of weeks ago, but other than that he’s had no exposure to anyone who’s been sick. He has not traveled anywhere recently, …
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A Pregnant Woman with Skin Lesions
A 30-year-old woman in her second trimester of pregnancy complained of multiple skin lesions that occurred in wheal patterns whenever she pressed firmly on her skin. Sometimes her skin would itch, causing her to apply pressure or rub and produce the wheal. Upon exam, the doctor could see a linear configuration on her arms from scratching and geometric configurations on her back, produced by her clothing View the image taken (Figure 1) and consider what …
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Fever, Conjunctival Injection, and a Facial Papule
Case A mother brings her 10-year-old son to an urgent care center with a fever, conjunctival injection, and pharyngitis. She points out a smooth papule on his face that developed over the last few days. She says that he played with some kittens at a friend’s house about a week earlier, and she wonders if maybe he is extremely allergic to cats, because he has been rubbing his eyes ever since. View the image taken …
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Hip Pain in an 80-Year-Old Woman
Case An 80-year-old woman presents to an urgent care center with left hip pain that she has had for 4 years but that has worsened in the last week. She reports that before the pain worsened, she had gone on a long walk with her grandson. The pain is worse with movement through the range of motion. She has taken ibuprofen, but it did not reduce her pain. She says that she has not had …
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Hyperpigmented Skin Patches
A 70-year-old man presents to an urgent care center after becoming concerned about brown hyperpigmented patches on his legs and arms. He says that he thinks some of his teeth are turning gray, but it has been happening so slowly that he is not sure. He reports that he has been in good health recently, especially after starting to take antibiotics last year to treat his rheumatoid arthritis. View the image taken (Figure 1) and …
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Shoulder Pain After Falling from a Tree
A 57-year-old man climbs a tree in his yard to trim branches, and then falls to the ground and onto his shoulder. In presenting to his local urgent care center, he reports that he has pain over his right shoulder and scapula area that is sharp and worsens when he moves through the range of motion. He says that he took 600 mg of ibuprofen after he was injured but that his pain did not …
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