Orthopedic Case Report

Urgent Message: Urgent care management of acromioclavicular joint separation consists of patient education on immobilization and pain management with consideration for emergency department referral when red flags are present. Jerome Walsh, BS; Clinton Hartz, MD; Michael B. Weinstock, MD Keywords: acromioclavicular joint separation; ac joint injury; shoulder trauma; rockwood classification; shoulder injury; urgent care Questions for the Clinician at the Bedside Which demographics are most likely to present with an acromioclavicular joint separation? What is the name of the classification system for acromioclavicular joint injuries? Which patients presenting with acromioclavicular …
Read More

Urgent Message: Identifying fall height and mechanism, while also relying on caregiver narratives, can help urgent care clinicians rule out severe pathologies and diagnose a toddler’s fracture in ambulatory pediatric patients after a fall. Connor Osmond, BA; Thomas Seebacher, DO Keywords: fractures, bone; tibial fractures; gait disorders, neurologic; radiography; accidental falls Editor’s Note: While the images presented here are authentic, the patient case scenario is hypothetical. Questions for the Clinician at the Bedside Which mechanisms and patient features are associated with a toddler’s fracture? What are the red flag signs …
Read More

Urgent Message: Patients presenting with radial wrist pain that is exacerbated by thumb and wrist motion may raise the suspicion for De Quervain tenosynovitis (DQT). Utilizing a clinically focused framework is important for the evaluation and management of DQT. Jacob Welch OMS-3, William O’Neal MD Keywords: wrist pain, De Quervain tenosynovitis, Finkelstein test, Eichhoff test Editor’s Note: The patient case scenario is hypothetical to enhance educational value. Abstract De Quervain tenosynovitis (DQT) is a frequent cause of radial-sided wrist pain, resulting from tendinopathy of the first extensor compartment. DQT is …
Read More

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 When should rheumatoid arthritis be suspected in patients with wrist pain? What history and physical exam findings help differentiate rheumatoid arthritis from other etiologies of wrist pain? What labs could be done …
Read More

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: What is a jersey finger, and how does it present clinically? What is the typical mechanism of injury? How is jersey finger diagnosed? When should patients with a …
Read More