Practice Management
The patient is a 36-year-old male who presents with left hip pain for “years.” The pain is motion- or position-related and over time there has been occasional pain in his buttock, back, and thigh. Additionally, he has stiffness, clicking, locking, and catching. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: Urgent care providers need to be vigilant for more than acute coronary syndrome, pulmonary embolism, and thoracic aortic dissection when patients present with chest pain—such as this 20-year-old who developed pneumomediastinum while smoking marijuana. Xiangyang Jiao, MD Case Presentation A 20-year-old female presented to urgent care for pleuritic chest pain and shortness of breath for about 2 hours. The chest pain was located in the upper and mid chest, was dull, pressure like, …
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Urgent message: Musculoskeletal pain is a common urgent care complaint, with x-rays very commonly ordered. However, a “normal” image does not necessarily support eliminating what could be a serious injury from the differential diagnosis. Arun Sayal, MD, CCFP(EM) Citation: Sayal A. When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging. J Urgent Care Med. 2022;16(7):13-16. Medical tests lie. Not intentionally, of course, but their result may not align with reality. A test may …
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Pediatric Pneumonia Signs and Symptoms of Cauda Equina Syndrome Removing ‘Stuck’ Rings Central vs Peripheral Acute Vertigo Zinc and Viral RTIs in Adults Nathan M. Finnerty, MD, FACEP; Joshua W. Russell, MD, MSc, FAAEM, FACEP; and Brett C. Ebeling, MD How Long Should Pediatric Pneumonia Be Treated? Take-home point: Lower-dose and shorter-duration amoxicillin treatment was noninferior to standard regimens for outpatient treatment of community-acquired pneumonia (CAP) in this trial. Citation: Bielicki JA, Stӧhr W, Barratt …
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Urgent message: The depth of COVID-19 testing data specific to the pediatric urgent care market provides insights into the capability of the broader urgent care industry to play a significant role in public health in the United States. David J. Mathison, MD, MBA It’s easy to forget how 24 months ago the urgent care industry was amidst one of the worst influenza seasons in recent memory. Then in February 2020, the first cases of COVID-19 …
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Urgent message: Urgent care centers can execute and implement innovative ideas to ameliorate overcrowded Emergency Rooms. The creation of a mobile health diversion program to transport low acuity conditions to urgent care instead of a hospital emergency department can improve population health and reduce healthcare cost; providing the opportunity to leverage value-based care by targeting the triple aim (reducing cost, increasing patient satisfaction, and improving outcomes) while freeing up the emergency medical system services. Cesar …
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The patient is a 46-year-old male with a history of hypertension and congestive heart failure who presents complaining of his defibrillator firing—twice yesterday and once today. He denies chest pain, shortness of breath, fever, nausea or vomiting. He ran out of his carvedilol about 1 month ago. View the initial ECG and consider what your diagnosis and next steps would be.
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The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis. View the image and consider what your diagnosis and next …
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The patient is a 31-year-old male who presents with lateral ankle pain after an inversion injury during a game of basketball. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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When Handlebar Meets Abdomen Corticosteroids and Asthma Antibiotics in Pediatric PAC Surfactant Use in AOM COVID Pneumonia and Disease Progression Neutralizing Antibodies in COVID Pediatric Abdominal Injuries from Handlebars Take-home point: Handlebar impact is a high-risk mechanism for serious intraabdominal injury in children and necessity of operative intervention is common. Citation: Vanderwalle R, Barker S, Raymond J, et. al. Pediatric handlebar injuries: more than meets the abdomen. Pediatr Emerg Care. 2021;37(9):e517-e523. Relevance: It is important …
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