Clinical Challenge 2: June 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 2 ½-year-old who presents with pain in the left ankle after receiving a blow to the lower leg. You find he is unable …

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Clinical Challenge: June, 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 4 1/2 -year-old girl who presents with local pain and swelling in the fifth digit of her left hand. The parents report that …

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Clinical Challenge: May, 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 50-year-old female who presents with pain in her right thumb after taking a fall. On examination, you not local swelling at the base …

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Clinical Challenge: April, 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 22-year-old male who fell and landed directly on his shoulder. On examination, you note marked local swelling and decreased range of motion. View …

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Clinical Challenge: March, 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 live to submit a case for consideration, please w-mail the relevant materials and presenting information to [email protected]. The patient is a 14-year-old boy who presents with low back pain after failing from “a high height” and landing on his feet. Exam is normal except …

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2-year-old boy with sudden pain in left leg

2-year-old boy with sudden pain in left leg

The patient is a boy, age 2 years 8 months, who presents with the complaint of pain in the left leg that started five hours ago. There is no history of trauma. On exam, the child looks well and has a temp of 98.96 degrees (axillary) and a pulse of 114. In addition, he has a WBC of 17.7, with 73.7 percent granulocytes. The child\’s leg has no external findings. There is clear pain on …

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Clinical Challenge: February, 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 17-year-old male who fell and experienced a blow to the right knee. On examination, you not local swelling. The patient complains of pain …

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Clinical Challenge 2: January 2010

The patient is a 20- year- old female who presents with pain one day after experiencing a blow to the knee during a fall. On exam, you reveal no significant findings beyond mild local tenderness. She is able to bear weight fully on both legs. 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: January, 2010

The patient is a 16-year-old male who presents with difficulty breathing and pain in his throat, along with difficulty swallowing and pleuritic chest pain. All the symptoms began “a couple of hours” prior to presentation. There is no history of trauma or choking, nor of a recent dental procedure. On exam, the patient looks well, and is quiet and not toxic; there are no sign of distress. Pulse is 75, O2sat 94 and there is …

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