Practice Management
A 79-year-old female presents to urgent care complaining of sharp, severe lower back pain for the past 2 months. The pain began when she was bending over to pick something up from the floor and has not improved. The pain occasionally radiates to her flank area but not down her legs, and she denies any bowel or bladder pattern changes. She tried acetaminophen, cold and warm compresses, and rest without any relief. The pain worsens …
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An 8-year-old male is brought to urgent care by his mother reporting a widespread, itchy facial rash. The patient says that the rash is severely painful and pruritic, and that he feels tingling and pain in his lips. The facial rash presented 3 days prior, and the mother states that her son repeatedly scratches the legions. The patient and is family are from Honduras; they deny any recent travel. The patient is otherwise well and denies …
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A 64-year-old woman with a history of chronic obstructive pulmonary disease, diabetes mellitus, osteoarthritis, and obesity presents to urgent care with acute right posterior ankle pain after stumbling on a curb earlier that day. She says she felt a sudden sharp pain in the back of her ankle and experienced immediate difficulty walking and climbing stairs. She reports 10 days of mild posterior ankle discomfort before this event, which she treated with ice, an elastic …
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An 83-year-old female with a past medical history of hypertension, diabetes mellitus, and hyperlipidemia presents to urgent care with palpitations and dizziness for the past 2 weeks. She does not have any family members present. 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 28-year-old female presents to urgent care complaining of right ankle pain after awkwardly stepping off a high curb, subsequently rolling her ankle while running outside earlier today. She is unable to bear weight on her ankle. She has no past medical history, takes no medications regularly, and has not tried any treatments since the injury. Physical exam reveals she is afebrile with normal vital signs, and she has marked tender edema to the lateral …
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A 28-year-old male with history of left shoulder dislocations presents to urgent care with severe left shoulder pain. He reports an inability to move the arm after injuring his shoulder while taking off his shirt. He reports feeling the shoulder “shift out of place” during the movement. On examination, the patient is in significant discomfort. He is holding the left arm in slight abduction with left shoulder external rotation. His elbow is flexed and his …
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A 12-year-old male presents to urgent care with his mother for left groin and buttock pain since acute onset while running in a track meet earlier today. He reports that he felt a pop while running a sprint race and was subsequently unable to finish the race or bear weight on his left leg due to pain. He has no other past medical history and takes no medications. Physical exam reveals that he is afebrile …
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A 38-year-old otherwise healthy male presents to urgent care with acute right knee pain following a 6-foot fall from a ladder, landing directly on his right lower extremity 2 hours prior to arrival. He reports severe pain and the inability to bear weight since the injury. Physical examination reveals that he is afebrile with normal vital signs. Musculoskeletal exam is notable for moderate knee effusion with surrounding early ecchymosis, and medial joint line tenderness. There …
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A 53-year-old male butcher visits urgent care for a painful red rash that developed on his hand 3 days prior. There is no history of recent travel, but he accidentally cut himself when processing meat 1 week ago. Exam reveals that the patient is febrile at 100.2° F. Otherwise, his vital signs are within normal limits, and he is well appearing. On dermatologic examination, erythematous vesiculated papules, plaques, and associated edema are visible on the …
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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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