Severe Hip Pain After a Motor Vehicle Accident

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 …

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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 …

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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 …

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Painful Metacarpophalangeal Joint After a Skiing Fall

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 …

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Constipation in a 67-Year-Old Man

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 …

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Productive Cough and Chills in an Adult

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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Knee Pain in an 8-Year-Old Boy

Knee Pain in an 8-Year-Old Boy

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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Foot Injury in a Weekend Warrior

Foot Injury in a Weekend Warrior

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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