Journal of Urgent Care Medicine

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.

A 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 …

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 …

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 …

Ten-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 …

Clavicular 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 …

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.

Painful Metacarpophalangeal Joint After a Skiing Fall

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 …

Constipation in a 67-Year-Old Man

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 …

Productive Cough and Chills in an Adult

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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