Practice Management
A 61-year-old male with a history of hypertension, diabetes, and chronic kidney disease presents to urgent care on a Tuesday afternoon with 1 week of increased weakness. He says he’s “feeling off balance.” He denies chest pain, shortness of breath, or recent illness. An ECG is ordered. 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 7‑year‑old male presents to the urgent‑care clinic with left‑knee pain that began after gym class and has gradually worsened over the past several weeks. The mother reports no significant trauma and notes that the pain improves with rest. Physical examination reveals a slightly overweight child with a visible bowing deformity just distal to the knee. The patient demonstrates a full range of motion and normal knee strength, and no bony tenderness, effusion, or laxity …
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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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The patient is a 55-year-old woman who presents with sudden-onset wrist pain in her right wrist. She reports that she is right-handed and played pickleball the day before onset, and that she is an avid bicyclist, but denies falling or experiencing any pain in the course of those activities. She says she “just woke up with it hurting.” View the image taken and consider what your diagnosis and next steps would be. Resolution of the …
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A 17-year-old high school lacrosse player presents to an urgent care center with a painful left ankle. He states that the pain started 2 days earlier when he twisted his left ankle (an inversion injury) while competing in a tournament. He says that he tried to continue to play, but the pain increased. He reports that the ankle swelled over the lateral aspect and that he has pain when he walks. He says that he …
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A 62-year-old woman presents with a rash that appeared simultaneously with the onset of ipsilateral facial palsy. She reports severe ear pain in the affected ear, along with hearing loss. Physical examination reveals grouped bullae and vesicles on an erythematous base ipsilaterally involving the auricle, external ear canal, and tympanic membrane, as well as the mouth and anterior two-thirds of the tongue. View the image taken and consider what your diagnosis would be.
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The patient is a 38-year-old female who presents with persistent pain in her left thumb. She explains that she was bitten approximately 2 months prior. There is redness and swelling to the proximal phalanx area. The patient is febrile. View the x-ray and consider what your diagnosis and next steps would be. Resolution of the case is described on the next screen.
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The patient is a 16-year-old female with right-side neck pain after inadvertently swallowing a chicken wing. She has not eaten and has imbibed minimal fluids for more than 24 hours. View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The patient is a 10-year-old boy who presents after twisting his right knee while playing a backyard game of badminton. The pain is such that he is unable to bear weight on the leg. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The patient is an otherwise healthy 35-year-old male who presents with posterior neck pain after a motor vehicle accident. View the image taken and consider what your diagnosis and next steps would be.
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