The patient is a 26-year-old who presents to urgent care after “twisting” the right foot, complaining of local pain but able to bear weight. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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16-year-old male falls from motorcycle, takes blow to right ankle
The patient is a 16-year-old male who fell from his motorcycle and received a blow to his right ankle. The motorcycle was moving at a “good pace.” On exam, he is able to weight bear, but with significant pain. You note swelling and tenderness over the medical malleolus. View the x-ray taken and consider what your diagnosis and next steps would be.
Read MoreClinical Challenge: May, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 50-year-old female who presents with pain in her right thumb after taking a fall. On examination, you not local swelling at the base …
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7-month-old boy falls from a bed
The patient is 7-month-old boy who presents with his parents one day after falling from a bed. The parents state that there was no loss of consciousness; the child looks well and has not vomited. The parents brought the child in out of concern from the fall. You opt to do a skull x-ray for the same reason. View the x-ray taken and consider what your diagnosis and next steps would be.
Read MoreClinical Challenge: April, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected] The Case The patient is a 22-year-old male who fell and landed directly on his shoulder. On examination, you note marked local swelling and decreased range of …
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2-year-old boy with Williams syndrome suffers fever and cough
The patient is 2-year-old boy with Williams syndrome who presents two days after a trip to the emergency room for a three-day history of fever, cough, and wheezing. In the ED, the parents report, he received three doses of nebulized albuterol and was diagnosed with reactive airway disease and bilateral otitis media. He was discharged on oral amoxicillin and albuterol MDI. Today, you find he has similar symptoms, plus vomiting. His parents say he vomited …
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2-year-old boy with sudden pain in left leg
The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …
Read MoreClinical Challenge: February, 2010
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 17-year-old male who fell and experienced a blow to the right knee. On examination, you not local swelling. The patient complains of pain …
Read MoreClinical Challenge 2: January 2010
The patient is a 20- year- old female who presents with pain one day after experiencing a blow to the knee during a fall. On exam, you reveal no significant findings beyond mild local tenderness. She is able to bear weight fully on both legs. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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35-year-old female catches finger in banister
The patient is a 35-year-old female who got her finger caught in a metal staircase banister one day prior to presentation. Physical examination is significant for right fifth PIP hyperextension and DIP hyperflexion (swan neck deformity). The patient\’s PIP flexion appears to be limited to about 20 degrees, while her contralateral PIP joint shows about 100 degrees of flexion. No sensory or motor deficits are noted. View the x-ray taken and consider what your diagnosis …
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