Practice Management
A 24-year-old male patient presents to urgent care with right wrist pain that started while playing golf 2 days ago. The patient recalls swinging the club and hitting the ground rather than the ball, felt a sharp pain in his hand which has been constant since the incident. He has not tried any treatments at home. The provider notes increased pain when the patient flexes his hand, along with a weakened grip compared to the …
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Urgent Message: Persistent, non-mechanical back pain should raise suspicion for non-muscular causes, and in this case, such pain in an older man was related to a diagnosis of metastatic prostate cancer with bone involvement. Rimsha Afzal, MA; Gregory M. Thompson, MD Key Words: Vertebral Metastases; Metastatic Prostate Cancer; Urgent Care Diagnosis Abstract Introduction: Back pain is a common presentation in the urgent care center. While the majority of diagnoses are self-resolving and of a musculoskeletal …
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Urgent Message: Forced hyperextension of a flexed digit may strain or rupture the flexor digitorum profundus tendon from the distal phalanx. Prompt diagnosis and treatment of acute injury are key in the prevention of permanent finger dysfunction. Alyssa Marchman, BS; Sarah Brouwer, BS; William Beauchamp, DO Key Words: Flexor Digitorum Profundus, Tendon Avulsion, Jersey Finger Questions for the Clinician at the Bedside: Editor’s Note: While the images presented here are authentic, the patient case scenarios …
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Urgent Message: While the evaluation of a chief complaint is a priority in urgent care, recognition of chronic disease progression is also critical. Eliana H. Kim, DO; Aaron J. Maki, MD, PhD Key Words: Anemia, Iron Deficiency, Down Syndrome, Trisomy 21, Transfusion, Strep Throat, Case Report Abstract Introduction: Often the chief complaint is the primary focus of urgent care visits. However, it is important to consider other aspects of the patient’s health, especially in pediatric …
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Cannabis Use and Cardiovascular Outcomes in Adults Take Home Point: This study suggests that cannabis use has a strong, statistically significant association with adverse cardiovascular outcomes independent of tobacco use. Citation: Jeffers A, Glantz S, Byers A, et. al. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024 5;13(5):e030178. doi: 10.1161/JAHA.123.030178 Relevance: Animal studies have previously shown endothelial cell dysfunction, a precursor to endovascular disease, occurs with cannabis use. …
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A 60-year-old male presents to urgent care with progressive dyspnea for 2 weeks associated with lower extremity edema. The patient is afebrile and slightly tachypneic with rales at the bilateral bases. 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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A 28-year-old female presents to urgent care with mild left lower quadrant (LLQ) abdominal pain that began earlier in the day. The discomfort is dull, intermittent, and non-radiating. She denies vaginal bleeding, fever, nausea, vomiting, or urinary symptoms. Her last menstrual period was approximately 2 months ago, although she reports a history of irregular cycles. She appears well and is hemodynamically stable. An abdominal exam reveals mild LLQ tenderness without rebound or guarding. A pelvic …
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A 75-year-old male presents to the walk-in clinic with the chief complaint of an asymptomatic rash on the left temple of his face that developed over the past 2 months. On examination, a shiny deep red papule is visible with scaly macules (actinic keratoses) surrounding. The patient is on rituximab for chronic lymphocytic leukemia (CLL). View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
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Urgent Message: While the initial clinical presentation of a high-pressure paint gun injury may not elicit concern, it is truly high-risk and requires emergent recognition and surgical intervention. Key words: High-Pressure Injection Injury, Paint Gun Injury, Finger Trauma, Pyogenic Tenosynovitis, Occupational Injury, Subcutaneous Paint Infiltration, Finger Compartment Syndrome, Finger Emergency Abstract Introduction: High-pressure injection injuries of the hand are rare but represent true surgical emergencies. Despite often appearing deceptively mild on initial presentation, these injuries …
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An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past. Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be …
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