Journal of Urgent Care Medicine

Wrist Pain in an Adult After a Fall

A 62-year-old woman presents with left wrist pain that began after she fell onto her outstretched left hand earlier in the morning while walking her dog. She has wrist pain throughout the range of motion, as well as some pain in her hand. She sustained no injuries to her head or neck, and she has no head pain, neck pain, chest pain, or shortness of breath.

Finger Injured by a Hammer Blow

A 33-year-old man presents to the urgent care 2 hours after hitting his middle finger of his left hand with a hammer. He has severe pain and has wrapped the finger in bacon. His pain increases as he moves through the range of motion, and he has numbness over the tip of the finger. He has no other injuries, and his tetanus immunization is up to date. View the image taken (Figure 1) and consider …

Shoulder Pain in a 62-Year-Old After a Fall

A 62-year-old man presents with right shoulder pain that began the previous evening after he fell in his garage. The pain is worse with movement through the range of motion. He has no pain in the elbow and says that he has no head pain or head injury. His social history reveals that he is a smoker and drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis would be.

Man with Fever and Sore Throat

A 37-year-old man presents to an urgent care center after 2 days of fever and sore throat. He reports that the soreness is worse with swallowing. He reports that he did not have any preceding rhinorrhea or myalgias. He has had no exposure to ill persons, and he has no history of previous illnesses. He reports that he smokes cigarettes and occasionally drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis …

Clinical Challenge: March 2016

A 36-year-old man comes to an urgent care center reporting pain in his back that began the previous day. The pain is sharp and worse with certain changes in position. He does a lot of lifting at his job stocking shelves in a grocery store, but he cannot relate the onset of the pain to any specific lifting that he has done. View the image taken (Figure 1) and consider what your diagnosis would be.

Sudden-Onset Left-Sided Chest Pain

A 32-year-old man with a history of pneumothorax presents to the urgent care after a sudden onset of left-sided chest pain that started 30 minutes earlier when he was inhaling while smoking a cigarette. He reports shortness of breath, dizziness, and diaphoresis. View the image taken (Figure 1) and consider what your diagnosis would be.

Generalized Abdominal Pain with Nausea

A 67-year-old man presents, reporting constipation that has lasted 3 days. He has a constant, generalized dull abdominal pain that is intermittently worse, occurring in what he describes as waves. He has nausea and reports that he has vomited once. He reports no blood in the urine or stool, and no weight loss, dysuria or urinary frequency, or dizziness. View the image taken (Figure 1) and consider what your diagnosis would be. Differential Diagnoses Small …

Ankle Injury Sustained During an Amateur Football Game

A 25-year-old man presents to the urgent care center after a backyard game of football in which he twisted his ankle. Because of alcohol intoxication, he cannot remember the mechanism of injury. He reports isolated right ankle pain and is unable to bear weight. On physical examination, he has pain with palpation of the ankle, but there are no gross signs of deformity. An ankle x-ray has already been done by the time you see …

Thoracic Pain After a Fall

A 51-year-old man presents to an urgent care center with sharp left thoracic pain that began suddenly after he fell after tripping on a banana peel that had been left on his kitchen floor. He has pain with breathing as well as with range of motion of the chest wall. He reports no head trauma, head or neck pain, fever, vomiting, or dizziness. View the image taken (Figure 1) and consider what your diagnosis would …

Chronic Cough and Shortness of Breath

A 74-year-old man without a significant past medical history presents to an urgent care center reporting 3 days of coughing productive of green sputum, shortness of breath that worsens with exertion, and chills. He says he has a chronic morning cough but states that the sputum has changed color and that his dyspnea has increased. He says he has not had any fever, chest pain, or lower extremity pain or swelling. View the image taken …

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