Practice Management
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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Web-Based Pediatric Point-of-Care Ultrasound Cases Take Home Point: Implementation of a web-based point-of-care ultrasound (POCUS) educational intervention resulted in improved learning outcomes and favorable participant evaluations among clinicians working in resource-limited settings. Citation: Ricci A, Lindsay D, Schwanfelder C, et al. Web-Based Deliberate Practice of Pediatric Point-of-Care Ultrasound Cases in Resource-Limited Settings: A Multicenter Implementation and Effectiveness Study. J Ultrasound Med. 2025;44(7):1231-1244. doi:10.1002/jum.16679 Relevance: POCUS is an increasingly valuable tool in clinical practice, providing rapid …
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A structured approach to evaluating acute musculoskeletal injuries may help reduce missed diagnoses and unnecessary imaging, according to a review article published in Cureus. Musculoskeletal complaints account for an estimated 20%–25% of emergency department visits, and the authors explain that combining injury mechanism, functional assessment, focused physical examination, and targeted imaging can help identify significant injuries. Validated clinical decision tools can safely reduce unnecessary radiographs while still achieving accurate diagnosis, they say. For example, the …
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Urgent Message: Necrotizing fasciitis may present without visible soft tissue abnormalities. Therefore, clinical signs and symptoms—including localized pain and tachycardia—are findings that should warrant further clinical investigation. Abstract Introduction: Necrotizing fasciitis (NF) is a severe, rapidly progressing soft tissue infection. Early NF may present to urgent care without visible soft tissue abnormalities. As such, clinical signs and symptoms, including localized pain with tachycardia, should warrant further clinical investigation. Case Presentation: A 43-year-old male presented to …
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Urgent Message: Training urgent care providers to use point-of-care ultrasound resulted in fewer patient transfers to the emergency department for soft tissue/musculoskeletal and first-trimester pregnancy complaints, while also streamlining care in this single-center program. Keywords: point-of-care ultrasound; urgent care; emergency department transfer; soft tissue infection; musculoskeletal complaints; first-trimester pregnancy Lindsey E. Fish, MD, FCUCM; Genie Roosevelt, MD; Amanda G. Toney, MD Abstract Introduction: The use of point-of-care ultrasound (POCUS) is expanding into multiple clinical areas …
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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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Comparing Point-of-Care Ultrasound With X-Rays in Pediatric Physeal Injuries Take Home Point: Point-of-care ultrasound (POCUS) demonstrated a high sensitivity in detecting traumatic bone and physeal fractures in children. However, it had only moderate concordance with x-rays (XR) in assessing the extension of the fracture into the joint space and Salter-Harris classification. Citation: Gurkan O, Kozaci N, Colak S, et al. Diagnostic accuracy of point-of-care ultrasonography in physeal fractures. Am J Emerg Med. 2026 Feb;100:198-204. doi: …
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Review of Evidence for Links of Autism with Maternal Acetaminophen Use Take Home Point: Existing evidence does not clearly link maternal acetaminophen (paracetamol) use during pregnancy with autism or attention deficit hyperactivity disorder (ADHD) in children. Citation: Sheikh J, Allotey J, Sobhy S, et al. Maternal paracetamol (acetaminophen) use during pregnancy and risk of autism spectrum disorder and attention deficit/hyperactivity disorder in offspring: umbrella review of systematic reviews. BMJ. 2025;391:e088141. doi:10.1136/bmj-2025-088141 Relevance: Recent public discussion …
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A 51-year-old male presents to urgent care after falling while skiing. He reports catching an edge in a patch of slushy snow, causing him to pitch forward and land forcefully onto his left anterior chest. He immediately experienced localized pain over the left chest, worsened by deep inspiration and coughing. He denies shortness of breath, syncope, and neck or head trauma. On exam, vital signs are normal. There is focal tenderness over the left anterior …
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A 52-year-old man presents to urgent care with a 2-day history of left calf pain, described as dull, non-radiating, and worsened by walking. He recently flew from Los Angeles to New York. His history includes hypertension managed with lisinopril. He denies fever, chest pain, shortness of breath, recent surgery, or prior clots. He appears well and is hemodynamically stable. Exam reveals mild swelling and tenderness in the left calf and popliteal region without erythema or …
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