Clinical Challenge 2: September 2010

The patient is a 32-year-old man who presents after experiencing a blow to the face while falling from a bicycle. The patient complains of tenderness over the front of his face. Neurological exam is normal. You note that his neck is supple. 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.

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Clinical Challenge: September, 2010

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 62-year-old who presents with a primary complaint of right shoulder pain that developed over time. The patient denies any trauma. The patient is …

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16-year-old male experiencing chest and throat pain

16-year-old male experiencing chest and throat pain

The patient is a 16-year-old male who presents with difficulty breathing, pain in his throat, difficulty swallowing, and pleuritic chest pain. He reports that the symptoms began “a couple of hours” earlier. There is no history of trauma, choking, or recent dental procedure. The patient looks well, and is quiet and not toxic. Pulse is 75, O2sat 94; there is no fever. Chest is normal, with bilateral air entry. Assessment is hindered by the patient’s …

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Clinical Challenge: July/August, 2010

In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please e-mail the relevant materials and presenting information to [email protected]. The patient is a 42-year-old who presents to urgent care after “twisting” her left foot. The patient is able to bear weight on the foot, though it …

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32-year-old male with burning sensation in chest

32-year-old male with burning sensation in chest

The patient is a 32-year-old male who woke up at 1 a.m. with a burning sensation in the mid-chest (a first-time event, he reports). The patient is not diaphoretic, and has no dyspnea. He is generally healthy and has no known risk factors for heart disease. His physical exam is unremarkable. In addition, you find: BP: 154/102 Pulse: 68 Sat: 99% Temperature: 97.3 °F View the EKG taken and consider what your diagnosis and next …

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