Practice Management
Urgent Message: Rupture of a Baker cyst is a rare complication and may manifest with the classic crescent sign of ecchymosis and swelling over the medial malleolus. Given the similarities in presentation to acute deep vein thrombosis, it is essential for urgent care clinicians to be able to differentiate between these diagnoses. Caroline S. Mifsud, DO, MS; Jennifer Ganzhorn, MD; Michael B. Weinstock, MD; Gregory M. Garrison, MD, MS, FAAFP; Elizabeth Westby, MD Keywords: Baker …
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AI Performs Well in Virtual Urgent Care Visits Take Home Point: This study indicates that an artificial intelligence (AI) algorithm was better at adhering to clinical guidelines and identifying critical red flags during virtual urgent care (UC) consultations, while physicians were better at adapting recommendations to changing information obtained during a patient consultation. Citation: Zeltzer D, Kugler Z, Hayat L, et al. Comparison of Initial Artificial Intelligence (AI) and Final Physician Recommendations in AI-Assisted Virtual …
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Urgent Message: Polymerase chain reaction testing is recommended for patients with lesions that could represent herpes simplex virus infection. It is imperative that urgent care clinicians understand the utility and characteristics of such testing as well as the implications of findings. Brittney Tice, FNP, DNP; Joseph Something, PA; Benjamin Zimmerman, PhD Editor’s Note: The patient case scenario is hypothetical. Abstract In the urgent care (UC) setting, patients commonly present with nominal requests for herpes simplex …
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A 13-year-old boy presents to urgent care after “rolling” his left foot. He explains that he tripped on a cement curb while riding his skateboard. He has foot and ankle pain that is worse with weight. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Urgent Message: While patients with asthma will frequently experience exacerbations following viral respiratory infections, the urgent care clinician must be cautious when assuming dyspnea is due to asthma. As dyspnea can be caused by a wide variety of conditions, it is important to maintain a broad differential diagnoses, even in patients with underlying asthma. Tracey Quail Davidoff, MD, FCUCM Key words: Influenza, Dyspnea, Asthma, Congestive Heart Failure, Myocarditis, Diagnosis Momentum Abstract Introduction: Patients commonly present …
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Can Doctors Predict Patient Outcome from a First Impression? Take Home Point: In this systematic review, the first impressions of “sick versus not sick” and appropriate patient disposition had reasonable predictive value for patient outcomes but was not sufficiently accurate to supplant thorough clinical assessment. Citation: Treloar E, Abraham A, Smith E, et. al. Can first impressions predict patient outcomes? Acad Emerg Med. 2025 Mar;32(3):351-354. doi: 10.1111/acem.15053. Relevance: In busy environments such as urgent care …
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A 33-year-old female presents to urgent care with pleuritic chest pain that is gradual in onset over the preceding several days and worse when lying flat. She denies fever, cough, and shortness of breath. She is well appearing with normal vital signs. 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 63-year-old man presents to urgent care with sudden-onset floaters and blurred vision in his right eye for one day. He denies trauma, headache, or flashes of light. He has no history of similar symptoms. His past medical history includes hypertension and type 2 diabetes. Vital signs are normal. Visual acuity measures 20/40 OD and 20/25 OS. No facial asymmetry or eyelid swelling is noted. Visual fields are intact bilaterally. A non-dilated fundoscopic exam is …
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A 55-year-old woman presents to urgent care because of skin dryness and scaling on her legs that developed 2 weeks prior. The patient was recently diagnosed with psoriasis by a different provider and was treated with a combination therapy of tazarotene and a topical steroid for over 4 weeks. Diffuse dryness and white scales were seen on her legs. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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Urgent Message: Compartment syndrome is a limb-threatening emergency that can present with variable clinical signs and symptoms. When the diagnosis is missed or delayed, poor functional outcomes and subsequent malpractice claims are common. Prevention of negative outcomes relies on early detection and a low-threshold for emergency department referrals. Josie L. Bunstine, DO; Ariel Cohen, DO Key words: Compartment Syndrome, Medical Malpractice Questions for the Clinician at the Bedside Abstract Acute compartment syndrome is a limb-threatening …
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