Journal of Urgent Care Medicine

A 31-Year-Old Male Complaining of Weakness

KEY QUESTIONS What Electrolyte disturbances cause the interval problem seen in this ECG? Which dysrhythmia is this patient at risk for?

A 22-Year-Old with Chronic Foot Pain

The patient is a 22-year-old male who presents for a pre-employment physical. During the exam, he mentions foot pain of several years’ duration, the origin of which he has no explanation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 37-Year-Old Female Presents with Sharp, Pleuritic Chest Pain

KEY QUESTIONS What features differentiate acute pericarditis from ST-elevation myocardial infarction? What are the criteria for diagnosing acute pericarditis? What are the treatment options?

A 21-Year-Old Male Presents with Altered Mental Status After a Vehicle Accident

KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?

A Young Man with Acute Ankle Injury

The patient is a 27-year-old man who complains of severe ankle pain and immobility after stumbling while on a hike. He fell approximately 1 foot onto a rock, landing with his foot in a forced flexion position. View the image taken and consider your next steps, along with possible diagnoses.

A 77-Year-Old Man Presents with Dyspnea

KEY QUESTIONS What diagnosis explains the widened QRS? What are the electrocardiographic criteria for making this diagnosis? What rule(s) can help diagnose acute myocardial infarction with an ECG like this?

A 14-Year-Old Wrestler with Shoulder Pain After a Match

The patient is a 14-year-old boy who reports to urgent care with left shoulder pain after a junior high wrestling match. He is vague about the precise location and possible mechanism of injury but through the physical exam you notice a prominence of the sternoclavicular joint and pain radiating along the clavicle. View the x-ray taken and consider what your diagnosis and next steps would be.

A 60-Year-Old Woman with Dark, Painful Plaques on Her Legs

The patient is a 60-year-old woman who presents to urgent care after developing dark areas over both legs over the course of the past few days. They are extremely painful. On examination, there were violaceous and dark brown, retiform plaques, some depressed and some crusted, over the legs. The patient has a history of diabetes, hypertension, and chronic renal insufficiency for which she required hemodialysis. View the image and consider what your diagnosis and next …

A 23-Year-Old with Wrist Pain After a Mountain Bike Mishap

The patient is a 23-year-old male who presents with a primary complaint of pain in his left wrist after falling from his mountain bike on a rocky path. 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.

A 10-Year-Old Boy Who Twisted His Knee in the Backyard

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.

Login to JUCM