Practice Management
A 67-year-old man visits urgent care for a lesion on his right ankle that was first noticed 25 years ago. He reports that it has progressively grown larger over the past 6 months. The lesion is painless but is intermittently mildly pruritic. The patient denies any recent injury or past medical history besides chronic venous insufficiency. On dermatologic examination, a discrete dark brown plaque is noted posterior to the lateral malleolus with numerous surrounding spider …
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An 84-year-old woman presents to urgent care with palpitations that have lasted for several hours. The patient is afebrile, slightly tachypneic on exam, with a blood pressure of 148/97 mm Hg. An ECG is obtained. View the ECG 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: The use of a computer in the urgent care examination room does not significantly impact patient satisfaction. As such, clinicians can use medical technologies in the exam room while maintaining confidence in the clinician-patient relationship. Justin Bowles, MD; Mitchell Lopes, MS4; Chaya Pflugeisen, MSc, MEd Keywords: electronic health records; physician-patient relations; patient satisfaction; ambulatory care facilities; communication; surveys and questionnaires Abstract Objectives: Primary care literature has shown that the use of technology in …
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Urgent Message: Brugada syndrome may present with subtle electrocardiogram findings, and clinicians must recognize the pattern promptly to help prevent sudden cardiac death. Katherine Quinn, MS IV; Eric Mast, DO; M. Drew Mattin, MS IV; Todd Fredricks, DO, MSS Keywords: sudden cardiac death; Brugada syndrome; Brugada pattern; ventricular fibrillation Abstract Introduction: Syncope in young, otherwise healthy individuals is often attributed to benign causes but can occasionally signal life-threatening cardiac conditions. Brugada syndrome (BrS), a rare …
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Urgent Message: This retrospective cross-sectional study found more than one-third of patients who presented to urgent care with rib injuries had rib fractures. Rib fracture was associated with male sex, older age, Spanish-speaking status, White race, and abnormal vital signs. Rebeka Sultana, MBBS; Kristin Breslin, MPH; Abigail Steiner, MS, MPH; Douglas B. Richardson, MAS; Lindsey E. Fish, MD Keywords: rib fracture; urgent care; chest wall trauma; pneumothorax; hemothorax; health disparities; logistic regression Research Supplemental Abstract …
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Urgent Message: Wrist pain and swelling are common presentations in urgent care. Several factors can help clinicians identify cases of rheumatoid arthritis in order to promptly refer patients to rheumatology. Christina Williams, BS; Veronica Heitsch, MD Keywords: rheumatoid arthritis; wrist pain; inflammatory arthritis; metacarpophalangeal joint; rheumatoid arthritis diagnosis; disease-modifying antirheumatic drugs Questions for the Clinician at the Bedside Editor’s Note: While the images presented here are authentic, the patient case scenario is hypothetical. Abstract Rheumatoid …
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“The more things change, the more they stay the same.” This quote by French writer Jean-Baptiste Alphonse Karr in 1849 is what rings true for me as I reflect on the 20-year anniversary of The Journal of Urgent Care Medicine (JUCM). Over the last 2 decades, the landscape of urgent care has changed drastically. Some highlights of those changes include significant growth in the number of urgent care centers and the number of urgent care …
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Chest X-rays for Abdominal Pain: Physicians’ Perspectives Take Home Point: In this study, emergency medicine physicians expressed favorable attitudes toward evidence-based medicine (EBM), although their clinical practices did not always fully align with the available evidence. Citation: Evans B, Giannotti N, Ekpo E. Examining emergency doctors’ perspectives and attitudes regarding evidence-based medicine and chest radiograph request for abdominal pain. Emerg Med Australas. 2025;37(6):e70178. doi:10.1111/1742-6723.70178 Relevance: Prior literature shows that chest radiographs (CXRs) contribute little to …
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Urgent Message: Low-risk plantar puncture wounds in healthy children can be safely managed without antibiotics. Parents should receive instructions for return precautions. Adam Brandon Bondoc, MD Keywords: plantar puncture wound; pediatric puncture wound; rubber-soled footwear; pseudomonas aeruginosa; antibiotic stewardship; foreign body risk Abstract Introduction: Puncture wounds that occur through rubber-soled footwear increase the risk of infection from Pseudomonas aeruginosa. Prophylactic oral fluoroquinolones are frequently provided to adults for high-risk injuries. However, pediatric care is complicated …
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A 38-year-old otherwise healthy male presents to urgent care with acute right knee pain following a 6-foot fall from a ladder, landing directly on his right lower extremity 2 hours prior to arrival. He reports severe pain and the inability to bear weight since the injury. Physical examination reveals that he is afebrile with normal vital signs. Musculoskeletal exam is notable for moderate knee effusion with surrounding early ecchymosis, and medial joint line tenderness. There …
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