Journal of Urgent Care Medicine

An Uncommon Cause of Rectal Pain: A Case Report of Fishbone Foreign Body

Urgent Message: Careful history and examination are required when assessing patients presenting with rectal pain. Clinicians should maintain a high index of suspicion for accidental foreign-body ingestion when assessing unexplained rectal discomfort. Ivan Koay, MBChB, MRCS, FCUCM, FRNZCUC, MD; Cameron Olphert, BSc (Hons), MSc Key Words: rectal pain; foreign body; proctoscopy; fishbone ingestion; hemorrhoids; gastrointestinal issues Abstract Clinical Presentation: A 50-year-old male with a history of type 2 diabetes mellitus and hemorrhoids presented to urgent …

Wheezing as a Pneumothorax Presentation: A Case Report

Urgent Message: For patients with presumed asthma exacerbation, clinicians must maintain a high index of suspicion for other etiologies, including pneumothorax. This may help avoid delays in potentially life-saving interventions when symptoms persist despite treatment or when physical exam findings are atypical. Badi Eghterafi, DO; Nazanin Hazhir Karzar, MD Keywords: asthma, wheezing, chest pain, pneumothorax, spontaneous pneumothorax Abstract Introduction: Large spontaneous pneumothorax is an uncommon but critical complication in patients with asthma. Clinicians evaluating presumed …

When Bell Palsy Is Actually a Stroke: A Case Report

Urgent Message: While Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis, it is important for urgent care clinicians to be able to quickly differentiate it from other more serious diagnoses. Keywords: facial palsy; stroke mimic; Bell palsy; central facial weakness; peripheral facial palsy; urgent care evaluation Luke Wisniewski, OMS3; Finley Kocher, OMS3; Muhammad Akhtar, MD Abstract Introduction: Bell palsy is the most common diagnosis for patients with unilateral facial weakness/paralysis …

Progressive Ankle Pain in a 12-Year-Old Male: A Case Report of Osteomyelitis

Urgent Message: While most pediatric musculoskeletal complaints are usually benign and self-limited, the urgent care clinician must consider more serious underlying causes of pain in the differential diagnosis. Keywords: pediatric osteomyelitis; atraumatic ankle pain; limping child; bone infection; ESR; CRP; MRI diagnosis Erin Loo, PA-C, MHA, FCUCM Abstract Introduction: Pediatric patients commonly present to urgent care (UC) with musculoskeletal complaints. However, a wide differential should be considered, including musculoskeletal injury, synovitis, autoimmune conditions, cellulitis, avascular …

Management of Acute Opioid Withdrawal in a Patient With an Unknown Prescribing History: A Case Report

Urgent Message: Opioid prescribing in urgent care can present difficulties, particularly in patients with an unclear prescription history where added caution is needed. There are a number of ways to reduce the risks associated with opioid prescribing and to initiate the treatment of opioid withdrawal in the urgent care setting. Jacob Mather, BSc MBChB Key Words: Addiction, Opioid Withdrawal, Prescribing, Urgent Care Abstract Introduction: We report a complex case of a 37-year-old woman presenting to …

Chronic Calf Pain and Limp: A Case Report of Pediatric Slipped Capital Femoral Epiphysis

Urgent Message: Pediatric patients frequently present to urgent care with musculoskeletal complaints, but clinicians must remain aware of the less common surgical and medical emergencies that can present with these symptoms. Key Words: Slipped Capital Femoral Epiphysis; Pediatric Limp; Antalgic Gait; Obesity; Urgent Care Diagnosis Abstract Clinical Presentation: A 13-year-old male presented to a pediatric urgent care with the chief complaint of left calf pain for a month that had acutely worsened over the past …

STEMI With Musculoskeletal Chest Pain: A Case Report

Urgent Message: Reproducible chest wall pain is often considered a symptom that indicates a musculoskeletal diagnosis. However, it should not be used as the sole criterion for ruling out acute coronary syndrome, especially in high-risk populations. Key Words: STEMI; Reproducible Chest Pain; Atypical ACS; Urgent Care Evaluation Abstract Introduction: Chest pain remains a leading cause of emergency department (ED) visits, and its differential encompasses both life-threatening and benign conditions. In the United States, the lifetime …

Worsening Otitis Media Despite Correct Treatment: A Case Report of Pediatric Leukemia

Urgent Message: Clinical worsening of typically treatable infections should trigger clinicians to dig deeper for possible underlying, undiagnosed conditions. Key Words: Pediatric Leukemia; Otitis-Conjunctivitis Syndrome; Persistent Infection; Urgent Care Diagnosis Abstract Introduction: Clinical worsening of typically treatable infections is a common initial presentation for pediatric patients with developing underlying oncologic conditions such as leukemia. Due to the gradual development of these conditions, patients may come to urgent care (UC) with varied and multiple presentations, which …

A Rare Cardiopulmonary Debut of Systemic Lupus Erythematosus: A Pediatric Case Report

Urgent Message: In adolescents presenting with persistent chest pain and systemic symptoms, clinicians should maintain a high index of suspicion for autoimmune etiologies such as systemic lupus erythematosus causing pericardial and pleural effusions. Asra Usmani, MBBS, MD; Ali Baidoun, MD; Aaron Mahoney, DO; Megan Sikkema, DO Key Words: Pericardial Effusion, Pleural Effusion, Systemic Lupus Erythematosus, Chest Pain, Adolescent Abstract Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune condition that can affect multiple organ systems. …

Back Pain From Vertebral Metastases in Prostate Cancer: A Case Report

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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