Journal of Urgent Care Medicine

Evaluating Decreased Libido: The Lowdown on Low T

Urgent message: Hypogonadism not only impedes biological development, but also negatively impacts a patient’s sense of identity and well-being. Prompt diagnosis is achievable through strategic utilization of hormone level testing in conjunction with a patient’s stated symptoms and medical history. Lisa O. Iyeke, BS and Mark J. Richman, MD, MPH Citation: Iyeke LO, Richman MJ. Evaluating decreased libido: the lowdown on low T. J Urgent Care Med. 2021;16(6):33-34. CASE PRESENTATION A 46-year-old male with benign …

Testicular Torsion: The Case of the Dancing Testicle

Urgent message: The differential diagnosis for unilateral testicular pain includes testicular torsion; this is a ”must not miss” diagnosis, as delayed diagnosis can cause significant morbidity both physically and psychologically. Jeannette Vaughn-Dotterer, PA-C CASE PRESENTATION ML is a 47-year-old male who developed left-sided testicular pain after getting out of bed 2 hours prior. He states that his left testicle appears to be “dancing” and seems to be riding higher than his right testicle. ML states …

See You in Court: Practice and Documentation Change from a Mock Trial

Urgent message: “Mock trials” are a valuable tool to help urgent care providers offer better medical care, record more appropriate documentation, and learn about medical proceedings. Michael Weinstock, MD; Kaetha Frost, DO; Heath Jolliff, DO; Amal Mattu, MD; Seth McIntire, DO; Marc Calvert, JD; Mark Kitrick, JD; and Matt Delaney, MD Citation: Weinstock M, Frost K, Jolliff H, Mattu A, McIntire S, Calvert M, Kitrick M, Delaney M. See you in court: practice and documentation …

Management of Scaphoid Injuries with Early Specialized Imaging at Urgent Care Clinics

Urgent message: Timely employment—and informed selection—of the most suitable mode of imaging are essential for correct diagnosis and optimal treatment of scaphoid injuries in the urgent care setting, often negating the need for referral to a higher-acuity setting. Muhammad Asim, MBBS, FRNZCUC, FRNZCGP and Rabeeah Asim, MBBS INTRODUCTION The scaphoid is the most commonly injured bone amongst carpal bones at the wrist, accounting for 10% of all hand fractures and 50% to 80% of all …

Abstracts in Urgent Care – February 2022

Surgery—or Not—for Appendicitis? Oral Analgesics and Musculoskeletal Extremity Pain What Patient Don’t Know About Ionizing Radiation Risk with NSAIDs, Cox-2 Inhibitors, and Opioids in Fractures Inhaled Budesonide for COVID-19 Spread of COVID-19 within the Household Ivan Koay MBChB, FRNZCUC, MD Nonoperative Management of Acute Appendicitis Take-home point: This study adds to a growing body of literature suggesting that, in select patients, a nonsurgical approach to appendicitis management leads to similar outcomes. Citation: The CODA Collaborative …

An 81-Year-Old Female with a History of A-Fib and a Recent Syncope Event

The patient is an 81-year-old female with past medical history of atrial fibrillation on apixaban who presents to urgent care after a syncopal episode 30 minutes prior to arrival. The patient felt lightheaded while being pushed in her wheelchair and then lost consciousness. There was no trauma. She returned to baseline approximately 2 minutes after the event. There was no seizure activity. The patient denied associated chest pain, shortness of breath, headache, urinary or fecal …

A 13-Year-Old Girl with Fever, Chills, Dry Cough, and Myalgia

A mother brings her 13-year-old daughter to your urgent care center with a complaint of fever, chills, dry cough, and myalgia for 3 days. On exam, the patient is febrile (101°F). In addition, there is conjunctival injection and blanching erythematous patches on the face and neck. The mother mentions that the family returned from a trip to Brazil 10 days prior. While traveling they ate local food, drank local (unfiltered) water, sustained a few mosquito …

A 30-Year-Old with a Painful Neck ‘Bump’ and Difficulty Swallowing

The patient is a 30-year-old male who presents with 2 days of difficulty swallowing and what he calls a painful “bump” on the right side of his neck. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

When Walk-Ins Aren’t Welcome

Patient volume has always been a delicate topic between the clinical staff and administrators of urgent care centers. It’s no secret who stands where in this ongoing debate. Regardless of each side’s opinions, UC volume has been largely stochastic historically, fluctuating at its own whim without regard for who wishes it were higher or lower. Things are different now, though. Thanks to COVID, UC overcrowding has become the new ED overcrowding—ubiquitous. The large volumes of …

Posterior Shoulder Pain—Not Always a Muscle Spasm

Urgent message: Patients present to urgent care with a variety of complaints, many of which are common—even if they are the result of an uncommon condition. It is important that the provider develop a broad differential diagnosis as they approach these problems. Richard A Ginnetti, MD, MBA, CPE and Justin Holschbach, MD CASE PRESENTATION History A 52-year-old male presents to urgent care with the chief complaint of new lower posterior neck and right shoulder pain …