Practice Management
A 32-year-old man presents to an urgent care center with pain at the metacarpophalangeal (MCP) joint of the thumb, from an injury sustained the previous week when he was skiing and fell onto his hand with his thumb extended. The patient has pain at the MCP joint with range of motion, but he says that he does not have any numbness. He has no fever, no breaks in the skin, no wrist pain, and no …
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A 67-year-old man presents with constipation that has been present for the preceding 2 days. He reports that he has had constipation in the past that resolved with the use of over-the-counter stool softeners, but this therapy has not worked with this episode. He has generalized abdominal pain that was mild initially but increased over the preceding day, which prompted his visit to the urgent care center. He describes the character of the pain as …
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A 37-year-old woman without a significant past medical history presents after 3 days of a cough that produces yellow sputum with some streaks of blood. She has not checked her temperature but says she has “felt warm” and has some chills. She does have associated shortness of breath, but she reports that she has not had chest pain, leg pain or swelling, sweating, or headache. She has a history of hypertension, and she takes an …
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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 …
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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, …
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A 38-year-old man presents to an urgent care center after falling from a ladder the same morning. He has pain in his right foot at the midaspect that is worse with movement through the range of motion. There is minimal associated numbness. There is no ankle pain, knee pain, fever, or vomiting. View the image taken (Figure 1) and consider what your diagnosis would be.
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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 …
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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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An 18-year-old high school lacrosse player presents to an urgent care center with a painful left ankle. He states that the pain started 2 days earlier when he twisted his left ankle (an inversion injury) while competing in a tournament. He says that he tried to continue to play, but the pain increased. He reports that the ankle swelled over the lateral aspect and that he has pain when he walks. He says that he …
Read MoreA 19-year-old college student presents to an urgent care center with pain at the distal interphalangeal (DIP) joint of the middle finger of his right hand. He reports that the pain started suddenly the previous evening when the finger was jammed while he was playing basketball. The pain is worse through the range of motion, but there is no numbness and no pain at the proximal interphalangeal (PIP) joint.
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