Journal of Urgent Care Medicine

NSAIDs in Urgent Care and Emergency Departments: A Narrative Review

Urgent Message: This narrative review of non-steroidal anti-inflammatory drugs (NSAIDs) characterizes the specific evidence-based indications, previous studies on dosing and route, and side effects of these medications. It supports NSAIDs as an important class of medications in the management of acute pain in urgent care and emergency settings. Campbell Belisle Haley, MD; Andy T. Hsueh, MD; Chih-Hsuan Chen, MD; Ariana M. Nelson, MD Citation: Belisle Haley C, Hsueh AT, Chen CH, Nelson A. NSAIDs in …

Delayed-Onset Facial Nerve Palsy Following Post-Auricular Gunshot Wound: A Case Report

David Hourani, MD; Bradley M. Golden, DO; Daniel McCollum, MD; John R. Barrett, MD Urgent Message: Mistaking traumatic facial paralysis for Bell’s palsy can delay treatment and have lifelong consequences. Prompt imaging and otolaryngology consultation are critical in determining disposition and management. Citation: Hourani D, Golden BM, McCollum D, Barrett JR. Delayed-Onset Facial Nerve Palsy Following Post-Auricular Gunshot Wound: A Case Report. J Urgent Care Med. 2024; 18(x):13-16. Keywords: facial nerve palsy; cranial nerve VII …

38-Year-Old With Pelvic Pain After a Fall

A 38-year-old man present to urgent care complaining of pain around his entire pelvis after a fall on a slippery floor at home. Imaging is obtained. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

21-Year-Old With Heel Lesion

A 21-year-old man presents to urgent care concerned about a painless blackish lesion that had developed on his left heel. On examination, a stippled, deeply violaceous, blackish patch with overlying scale was seen on his plantar heel. He had no history of dermatological disease but mentioned he played in a basketball tournament last week. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on …

61-Year Old With Light-Headedness

A 61-year-old male presents to urgent care complaining of light-headedness. The patient has a medical history of hypertension and recently started metoprolol. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Abstracts in Urgent Care – April 2024

Rehabilitation in Post-Acute Anterior Shoulder Dislocation Take Home Point: This study suggests that routinely referring patients to a program of physical therapy is not superior to a single session of advice, supporting materials, and option to self-refer to physical therapy. Citation: Kearney R, Ellard D, Parsons H, et. al. Acute rehabilitation following traumatic anterior shoulder dislocation (ARTISAN): pragmatic, multicentre, randomised controlled trial. BMJ. 2024 Jan 17:384: e076925. doi: 10.1136/bmj-2023-076925. Relevance: Shoulder dislocations commonly present to …

How Useful Is Ultrasound in Acute Female Pelvic Pain?

Andrew Alaya, MD, MSc Urgent Message: For time-sensitive diagnoses related to acute pelvic pain, ultrasound is generally the recommended initial diagnostic imaging study. While not universally available in urgent care, it can often be completed more rapidly than computed tomography or magnet resonance imaging. Citation: Alaya A. How Useful Is Ultrasound In Acute Female Pelvic Pain? J Urgent Care Med. 2024;18(7):35-40 Introduction Acute pain in the pelvic or lower abdominal region among women of reproductive …

Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures

Urgent Message: It’s important to recognize the difference between a proximal 5th metatarsal fracture of the tuberosity alone and a proximal metaphyseal fracture, commonly referred to as a “Jones fracture.” A Jones fracture requires full immobilization with urgent surgical referral. Michael B. Weinstock, MD; Kelly Moore, BS Citation: Weinstock M, Moore K. Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures. J Urgent Care Med. 2024 18(7):25-28 Editors’ Note: While the images presented here …

42-Year-Old Soccer Player With Knee Injury

A 42-year-old man presents to urgent care with knee pain. He says the pain started when he was playing soccer, just as he kicked a ball toward the goal. Ultimately, he had to leave the game because of the pain. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

38-Year-Old With Rash After Heating Pad Use

A 38-year-old woman presented to urgent care for rash that had developed on her trunk 2 months prior. On examination, extensive hyperpigmented, reticulated patches were seen on her back. She had no recent history of sunburn, extensive sun exposure, or history of dermatological conditions. Additional history revealed the use of a heating pad for the preceding 3 months to help manage her chronic back pain. She often rested on the electric heating pad for several …

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