The patient is a 7-year-old boy who presents to urgent care at midnight with a four-day history of fever and cough. Two days prior, a throat culture administered elsewhere showed nothing suspicious. The parents brought him to urgent care tonight because of increasing chest pain, which began after the visit to the primary care physician. On exam, you find the child is not in respiratory distress, but has decreased air entry on the left side …
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Young child with 3 days of constipation
The patient is a young child with three days of constipation with a non-specific history of abdominal pain. On exam, the child is asleep. The abdomen is easily palpable and soft. Physical exam reveals no other remarkable factors. View the x-ray taken and consider what your diagnosis and next steps would be.
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13-year-old male injures hand while bracing fall
The patient is a 13-year-old male who presented to urgent care after taking a fall while running; he landed on his outstretched left hand. Upon examination, you find tenderness in the snuffbox and observe swelling around the wrist. Otherwise, the findings are unremarkable. View the x-ray taken and consider what your next steps would be.
Read MoreA 34-Year-Old Male Who Injured His Finger
This patient, a 34-year-old male whose pre and post-reduction x-rays are shown here (Figure 1 and Figure 2), presented to urgent care after sustaining an axial injury to his fourth left finger while playing a weekend game of football. FIGURE 1. PRE-REDUCTION Reduction proved physically chal- lenging to more than one practi- tioner. A physician who happened to be on site tried unsuccessfully to reduce the dislocation at the time it occurred, then recommended the …
Read MoreClinical Challenge: July 2008
The patient is a 2-year-old girl who experienced a blow to the left foot when she jumped from an unspecified height while playing. The parents were unaware at the time the injury occurred, but toward evening the girl refused to apply weight to her left foot. On exam, the foot is mildly swollen and tender. Otherwise, there are no remarkable findings. View the x-ray taken (Figure 1) and consider what your diagnosis and next steps …
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2 1/2-year old has swollen elbow after falling
The patient is a 2½ -year-old female who presented after falling, unobserved, from an unknown height with tenderness and swelling around the elbow. Neurovascular exam was normal. View the image taken and consider what your diagnosis would be.
Read MoreClinical Challenge: June, 2008
The patient is an 80-year-old man who presents to urgent care with low back pain of two weeks duration. He is hemodynamically stable and has a normal neurological exam. His personal medical history reveals hypertension, for which he is being treated. Blood pressure is 140/80, pulse 63. View the x-ray 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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25-year-old man with back pain after falling 2 stories
The patient is a 25-year-old male who presented to urgent care after falling from a height of two stories, landing flat on his feet. He is able to ambulate, though only with pain. In addition, he complains of back pain. He is generally healthy, and no neurological deficit was found. View the image taken and consider what your diagnosis would be.
Read MoreClinical Challenge: May, 2008
This male patient presents to urgent care after, he claims, falling from a ladder. He refuses to give further details, except to say that the distance he fell was “not high.” View the x-ray 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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3-year-old female with foot pain after fall
The patient is a 3-year-old female who presented after a fall while running, complaining of pain over the foot. There was minimal local tenderness over the foot and minimal limp, but no other remarkable findings. View the image taken and consider what your diagnosis would be.
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