Journal of Urgent Care Medicine

Outdated Regulations Hamper Urgent Care X-ray Services

Recently, the Rochester Regional Health system in New York discontinued on-site x-ray services at 2 urgent care centers and reallocated those radiology technologists (RTs) to other urgent cares in the system that have higher patient demand, according to a local news site. Such optimization strategies could become more common in urgent care, given the state-specific requirements for radiology staff and the RT shortages across the nation. The reallocations of staff and discontinuations of x-ray services …

12-Year-Old Boy With Left Groin and Buttock Pain

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 …

Who Can Take X-Rays in an Urgent Care Center: A 50-State Framework

Urgent Message: This 50-state framework details who can legally operate x-ray equipment, as these laws dictate whether the industry’s predominant advanced practice provider-staffing model remains operationally and financially viable. Alan A. Ayers, MBA, MAcc Keywords: urgent care; radiography; radiologic technologists; licensure; nurse practitioners; physician assistants According to the Urgent Care Association (UCA), on-site plain-film radiography is a defining feature of urgent care and is among the criteria for UCA Certification.¹ Yet across the 50 states …

Cases of Ingested Water Beads Rise 6,000%; X-rays May Not Help Clinicians Diagnose

Toy blasters that shoot water beads are popular among kids as well as some adults, and most blasters cost less than $50 with a supply of thousands of water beads. The concern is that the colorful beads look like candy and may be attractive to young children. More than 20,000 water bead ingestions in children younger than 6 years were reported to U.S. poison centers between 2019 and 2024, as published in Academic Pediatrics. The …

Imaging Ranks As Top Service Among Outpatient Visits

Nationally, imaging accounted for 24% of all outpatient visits and 17% of outpatient spending in 2022, according to a new issue brief from the Health Care Cost Institute (HCCI). Only diagnostic testing and labs accounted for a larger proportion of outpatient visits by category (31%). Mammography and chest x-rays are the most common among imaging services. In terms of reimbursement, commercial payment for imaging is higher than what Medicare pays, with commercial reimbursement averaging 245–314% …

Deepfake X-Rays Could Be Hard To Spot

A new study in Radiology evaluated whether radiologists in 6 different countries could distinguish AI-generated (“deepfake”) radiographs from real images. In a subsequent phase of the study, 4 large language models (LLMs) were also tasked with deciding which images were authentic and which were deepfakes. Among 17 practicing radiologists, only 41% recognized AI-generated images as having poor technical quality at first look (“Did you notice anything unusual about these images?”). After learning that some images …

Proposed X-Ray Rules Heighten Radiation Protection Standards

Newly proposed legislation in Arizona aims to regulate radiation safety beyond the current federal and state standards, according to AZ Mirror. Proponents say the package represents a first-in-the-nation push focused on “radiation protection systems” for interventional x-ray. For example, it requires hospitals performing real-time x-ray procedures to install enhanced protection systems in at least 50% of their procedure rooms by July 2027, and the system must include shielding that offers protection equivalent to or better …

11-year-old With Heel Pain While Running

An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past. Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be …

Urgent Care Evaluation and Management of Suspected Lisfranc Injuries

Urgent Message: Rapid identification of Lisfranc injuries in urgent care is critical, as delays in diagnosis can lead to chronic disability. Most patients with Lisfranc fractures or dislocations should be referred directly to the emergency department. Cross-sectional imaging (ie, computed tomography) and orthopedic consultation are time-sensitive, and urgent operative repair is often indicated. Alexandra Eby, BS; Nicole Meschbach, MD Questions for the Urgent Care Clinician at the Bedside Abstract A Lisfranc injury is a tarsometatarsal …

51-Year-Old With Hemoptysis

A 51-year-old man presents to urgent care complaining of night sweats and a productive cough with visible blood for the past 2 weeks. He says he’s been feeling rather tired lately. A chest x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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