Practice Management
Urgent message: Acute rheumatic fever is not common but it does still occur, underscoring the need for head-to-toe examination in patients with vague symptoms that seem unconnected. HEATHER VARLEY, PA-C, and WILLIAM GLUCKMAN, DO, MBA, FACEP Introduction Patients with fever, sore throat, and malaise often present in the urgent care setting and they typically are worked up quickly with a rapid strep test or given a diagnosis of a viral syndrome. The case described here …
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Urgent message: Thoroughly evaluate patients who complain of dental or oral pain. CHRISTOPHER MCKENNA and JOHN SHUFELDT, MD, JD, MBA, FACEP Ludwig’s angina is a serious and potentially life-threatening connective tissue infection found on the floor of the mouth and in the deep neck spaces. More specifically, it is a bilateral infection of the submandibular space. The two compartments affected are the sublingual space and the submylohyoid space.1 This condition usually presents in individuals who …
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Urgent message: Infectious flexor tenosynovitis is an orthopedic emergency that can cause long-lasting disability through tendon necrosis and permanent digital contracture if unrecognized or mismanaged. MARY A. LANE, MD Flexor tenosynovitis is an inflammation of the tendon sheath that can be caused by either introduction of infection or various inflammatory conditions ranging from autoimmune arthropathies to crystal joint depositions. Flexor tenosynovitis caused by infection is an orthopedic emergency. It can cause long-lasting disability through tendon …
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Urgent message: Always be mindful of the ‘zebra’ in a stampede of ‘horses’ in the differential diagnosis. ELISABETH L. SCHEUFELE, MD, MS, FAAP Case Presentation J.H. is a 19-year-old Hispanic male presenting with abdominal pain and shortness of breath for the last 4 days. He had visited the urgent care clinic about 2 days before with similar symptoms and was discharged with a diagnosis of muscle strain. J.H. returned with persistent symptoms and he indicates …
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Urgent message: Back pain with incontinence and focal neurological changes are red flags for serious conditions. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Low back pain is a common presentation in the urgent care setting and it is important for providers to be aware of signs and symptoms that could indicate a more serious condition than nonspecific muscular pain. Be sure to make a thorough evaluation of your patients and pay …
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