A 5-Year-Old with Foot Pain of Unknown Origin

A 5-Year-Old with Foot Pain of Unknown Origin

A father brings his 5-year-old son to your urgent care center with a primary complaint of pain in his right foot. There was no report of trauma or injury. Dad has noticed the boy limping for the past few days and he points to the right foot. You note swelling in the midfoot area. The boy’s pain is evident as he walks with a limp and has tenderness in the area of swelling on the …

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Chin Lacerations in Children—A Call for Caution

Chin Lacerations in Children—A Call for Caution

Urgent message: Adhesive repair for skin lacerations in pediatric patients is a viable (sometimes preferable) option—under the right circumstances. Careful consideration is warranted when the wound is to the chin. Joshua Sherman, MD and David Mathison, MD, MBA INTRODUCTION The use of adhesive repair in lieu of sutures for the management of minor lacerations has become increasingly commonplace.1 When used correctly, cosmetic outcomes are similar and may be superior to suture repair in certain situations. …

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A 2-Year-Old Girl with Leg Pain After Jumping on a Trampoline

A 2-Year-Old Girl with Leg Pain After Jumping on a Trampoline

Case The patient is a 2-year-old girl who is brought to your urgent care center by her parents several hours after jumping on a trampoline with her friend, but that she “seemed fine” when the mother picked her up to come home. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. The Resolution Differential Diagnosis Acute transverse fracture of the …

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Pitfalls in Assessing and Managing Common Pediatric Injuries

Pitfalls in Assessing and Managing Common Pediatric Injuries

Urgent message: Fractures, in general, are relatively common among pediatric patients. Those most likely to be seen in the urgent care setting include injuries to the radius, ulna, humerus, lateral condyle, clavicle, tibia, and fibula. The second of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD As noted in part 1 of this article (published in the February 2011 issue of JUCM and available at www.jucm.com), fractures are common injuries in …

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Pitfalls in Assessing and Managing Common Pediatric Injuries

Pitfalls in Assessing and Managing Common Pediatric Injuries

Urgent message: Fractures are common among pediatric patients. Familiarity with the growth process and the unique properties of the immature skeleton—as well as immediate identification of conditions requiring emergent referral—are necessary for appropriate care and avoidance of long-term sequelae. The first of two parts. Justin Kunes, MD, Shane R. Hanzlik, MD, Allison Gilmore, MD Injuries that ultimately prove to be fractures are a common cause of visits to the emergency room and urgent care among …

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