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 …
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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 …
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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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Forearm Pain in a 12-Year-Old Patient After a Fall
A 12-year-old girl presents to an urgent care center with pain in her right forearm. She reports that the pain started the previous evening when she tripped on a toy left out by her 2-year-old brother. The pain is worse with range of motion. She says she does not have any numbness. She has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreShoulder Injury During Football Game
An 11-year-old boy presents with pain over the right clavicle that developed the previous day while he was playing football and another player fell on him. He has pain with range of motion of the right shoulder as well as with movement of the torso. He has no shortness of breath, chest pain, dizziness, or numbness of the arm. View the image taken (Figure 1) and consider what your diagnosis would be.
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Painful Defecation in a Child
An 8-year-old previously healthy boy with no history of skin disease presents with painful defecation and blood-streaked stools. He says that the perianal area does not itch. Physical examination findings are significant for well-defined perianal erythema and an anal fissure. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: December, 2015
Case A 56-year-old woman presents after a fall onto her outstretched hand. She has pain with range of motion of the wrist. She has no associated numbness or weakness and reports no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge 2: November, 2015
Case A 67-year-old man presents with constipation and abdominal pain that has been present for the last 2 days. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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Red Painful Eye with Visual Loss
A 29-year-old contact lens wearer presents to the urgent care center with a red eye, eye pain, and visual loss that has been increasing over the past 12 hours. Examination shows an injected conjunctiva with ciliary flush, and a cornea with white infiltrate in the stroma. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: November, 2015
Case A 56-year-old woman presents to an urgent care center with severe ankle pain after stepping off a curb. The physician obtains a radiograph of her ankle. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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