Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing

Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing

Urgent message: Although back pain is often due to benign etiologies, symptoms of progressive pain, weakness, and near syncope in one patient ultimately led to a diagnosis of renal cell carcinoma. Citation:  Hamazaspyan A, Kedia A, Weinstock M. Case Report of Renal Cell Carcinoma Presenting to Urgent Care with Indolent Back Pain: A Wolf in Sheep’s Clothing. J Urgent Care Med. 2024;18(5): 17-22. Anahit Hamazaspyan DO; Ayush Kedia DO; Michael Weinstock MD Abstract Introduction Back …

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Pediatric Knowledge Needs Assessment: A Pilot Study

Pediatric Knowledge Needs Assessment: A Pilot Study

Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …

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Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis

Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis

Urgent Message: Headaches are common, but when patients present with concurrent psychiatric symptoms, seizures, and signs of increased intracranial pressure, clinical teams might consider asking about recent travel to assess for possible neurocysticercosis. Naail Tariq, Cavan Scheetz, Michael Weinstock, MD Citation: Tariq N, Scheetz C, Weinstock M. Headache and Paranoid Delusions: A Case Report of Missed Neurocysticercosis. J Urgent Care Med. 2023;17(X);31-34. Abstract Introduction Headache is a common urgent care complaint. While most headaches have …

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When a Bleeding Hemorrhoid Is a Sign of Something More Sinister

When a Bleeding Hemorrhoid Is a Sign of Something More Sinister

Urgent Message: An expanded list of differential diagnoses can help clinicians identify when isolated bleeding is related to a more serious condition, as was the situation with this case of acute lymphoblastic leukemia. Download the article PDF: When a Bleeding Hemorrhoid Is a Sign of Something More Sinister Naushair Hussain, MD, Ahmad Ali, MD, Michael B. Weinstock, MD Citation: Hussain N, Ahmad A, Weinstock M. When a Bleeding Hemorrhoid Is a Sign of Something More …

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Back Pain, an Urgent Care Visit—and a Devastating Outcome

Back Pain, an Urgent Care Visit—and a Devastating Outcome

Urgent message: By the time an adverse outcome occurs in the urgent care center, it’s too late to go back and ensure the documentation reflects the care the patient received. Lyndsie Pfeifer, DO; Marta Fratczak, Kinkela Harkins, and Michael Weinstock, MD Citation: Pfeifer L, Fratczak M, Harkins K, Weinstock M. Back pain, an urgent care visit—and a devastating outcome. J Urgent Care Med. 2023;17(8):13-17. Key words: back pain, documentation INTRODUCTION It’s easy to let our …

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A Cause of Dizziness Not to Be Missed

A Cause of Dizziness Not to Be Missed

Urgent message: Most cases of vertigo are benign. This includes etiologies such as benign paroxysmal position vertigo, labyrinthitis, and psychogenic causes. However, there are serious, “can’t miss” etiologies which should be considered during the urgent care evaluation of a dizzy patient. Cody McCoy, DO and Michael Weinstock, MD Citation: McCoy C, Weinstock M. A cause of dizziness not to be missed. J Urgent Care Med. 2023;17(5):13-16. Key words: dizziness, vertigo, disequilibrium, BPPV INTRODUCTION Dizziness presents …

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When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

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A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

Michael Weinstock, MD; Gabby Gostigian, MD; and Matthew Delaney, MD Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. INTRODUCTION Cellulitis from a wound infection in the urgent care is common, and so is our management: wound care and antibiotics. But consider a scenario in …

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Psychiatric Manifestations of Organic Disease: Don’t Get Fooled!

Psychiatric Manifestations of Organic Disease: Don’t Get Fooled!

Urgent message: Mistaking medical symptoms for psychiatric disease can delay care and lead to adverse outcomes. Elizabeth Yeager-Cordial, MD; Janell Ison, DO; Robert Becker, MD; Courtney Boyd, MD; and Michael Weinstock, MD Citation: Yeager-Cordial E, Ison J, Becker R, Boyd C, Weinstock M. Psychiatric manifestations of organic disease: don’t get fooled! J Urgent Care Med. 2022;16(11):11-15. CASE PRESENTATION A 23-year-old man presented with a strange complaint: visual hallucinations. He had no psychiatric history and was …

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No Troponin, No Problem: Reimagining Chest Pain Assessment in Urgent Care

No Troponin, No Problem: Reimagining Chest Pain Assessment in Urgent Care

Most urgent care providers loathe when a patient checks in with chest pain because, typically, they are presenting because they’re worried about a heart attack, and we’re worried we don’t have the tools to exclude this diagnosis. It’s no surprise that we’re met with consternation when we suggest they may have come to the wrong place for care. But is unavailability of troponin testing a worthy scapegoat? And is the practice of ED referral for …

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