The patient is an 82-year-old man who presented after having fallen backwards and landing on his back. He did not lose consciousness; nor did he vomit. The patient entered the clinic using a walk- er, which he reported using on a regular basis. Examination revealed an abrasion over his forehead and over the anterior right tibia. The neurological exam showed no acute changes. The patient was specifically tender over the shoulder, but there was no …
Read MoreAbstracts in Urgent Care: April, 2008
Non-Steroidal Anti-Inflammatory Drugs for Low-Back Pain (Review) Key point: NSAIDS are more effective than placebo, are all similar in efficacy, and do have significant side effects. COX- 2 seems to have fewer side effects; however, the recent data on CV side effects is a concern. Citation: Roelofs PDDM, Deyo RA, Koes BW, et al. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD000396. Â DOI: 10.1002/14651858.CD000396.pub3. The authors searched the MEDLINE and EMBASE databases …
Read MoreClinical Challenge: March, 2008
The patient is a 15-year-old boy who presented two days after experiencing a blow to both ankles and the right knee. He could bear weight minimally, with tenderness over the lateral and medial malleolus, as well as over the knee. There was marked swelling View the x-rays 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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30-year-old male in severe discomfort after "twisting" ankle
The patient is a healthy 30-year-old male who presents with pain shortly after “twisting” his ankle while playing soccer. Pain is severe enough to prevent him from putting weight on the ankle. There are no other remarkable findings from exam or patient history. View the image taken and consider what your diagnosis would be.
Read MoreClinical Challenge 2: February 2008
The patient is a 3 ½-year-old girl who fell from a bicycle, receiving a blow to the elbow a short time before presentation. She had marked swelling and local tenderness over the elbow. The only other remarkable finding was a pulse of 132. 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.
Read MoreClinical Challenge: February, 2008
The patient is a 9-year-old girl who fell and received a blow to her right chest. A few hours later, she presented to urgent care complaining of pain on deep breathing. On exam, you find a pulse of 103, and SAT of 96. She is not in respiratory distress; her chest exam was clear and she has an abrasion over her right chest. She is generally healthy, is on no medica- tions, and has no …
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55-year-old man with knee pain after fall
The patient is a 55-year-old man who presented complaining of pain after experiencing a fall on the street and a blow to the knee. View the x-ray taken and consider your diagnosis and next steps.
Read MoreClinical Challenge: January, 2008
The patient is a 26-year-old male who slipped and twisted his left ankle. He is unable to bear weight on the ankle and there is marked local swelling circumferentially around the ankle. Oth erwise, he is generally healthy. View the x-ray taken (Figure 1) and consider what your diag- nosis and next steps would be. Resolution of the case is described on the next page.
Read MoreClinical Challenge 2: December 2007
The patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presented with local swelling and tenderness on exam, complaining of severe pain in his wrist. View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 14-year-old who took a fall two hours prior to presenting to the urgent care clinic
The patient is a 14-year-old who took a fall two hours prior to presenting to the urgent care clinic. The left ankle is swollen and unable to bear weight, but the patient is otherwise  healthy. 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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