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 …
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Wrist Pain After Tripping and Falling
A 35-year-old woman presents to an urgent care center with severe right wrist pain after a fall onto her outstretched hand after tripping on the sidewalk. She has significant pain throughout the range of motion as well as at rest. She has minimal numbness of the fingers. She has no other visible injuries, and on questioning, she reports that she has no elbow, shoulder, head, or neck pain. View the image taken (Figure 1) and …
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Pain 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 …
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Ankle Injury Sustained During a Step Off a Curb
A 56-year-old woman with a past medical history of hypertension presents to an urgent care center 1 hour after she injured her ankle while stepping off a curb. She believes that the ankle “twisted inward” but is not sure. She reports sharp, severe, constant pain throughout the joint and that worsens when she attempts to move the ankle through the range of motion. There is no numbness of the foot or ankle, no pain at …
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Severe Hip Pain After a Motor Vehicle Accident
A 62-year-old woman presents to an urgent care center with severe left hip pain that began several hours earlier after a motor vehicle accident. She was the driver, and she was wearing a seat belt. Her car’s driver-side air bag deployed when her car, moving at about 35 miles per hour, rear-ended a stopped car. She refused to be transported from the accident scene by emergency medical services for treatment because her only issue was …
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 …
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Facial Papules in an Adult
A 35-year-old man with a history of human immunodeficiency virus presents with smooth, skin-colored pearly papules with central umbilication on his cheeks, chin, and lateral neck. View the image taken (Figure 1) and consider what your diagnosis would be.
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