Journal of Urgent Care Medicine

A Rare but Insidious Cause of Abdominal Pain

Urgent message: Recognizing the need for workup and referral in patients, even if their symptoms are relatively common, is crucial for optimal outcomes Introduction Abdominal symptoms can be attributed to a wide array of causes. When etiology is not immediately apparent, searching for signs and symptoms the patient may not have reported—or even be aware of—may be the first steps toward timely diagnosis and treatment. In this case, the abdominal symptoms were ultimately due to …

Initially Missed Diagnosis of Quadriceps Partial Tendon Tear

Urgent message: Quadriceps tendon tears are misdiagnosed frequently, leaving patients at excessive risk for long-term disability. Early identification and immediate referral for further care—often, surgery—is necessary for optimal outcomes. Low-riding patella (patella baja) commonly seen in complete tendon tears. (Photo courtesy of Wikimedia Commons.) Introduction Musculoskeletal injuries are among of the most common problems seen in the urgent care setting. Quadriceps tendon tears are uncommon injuries, with an incidence of approximately 1.4/100,000 per year. Consequently, …

Painful Nose Crusting in a Child

Urgent message: Common nasal infections can have serious health consequences if not quickly diagnosed and treated. Introduction Both children and adults present to urgent care centers with nasal pain. Infectious causes of such pain include impetigo, furuncles, and nasal vestibulitis (NV). Noninfectious causes include squamous cell cancer and lupus vulgaris. A careful physical examination and a thorough medical history can allow the health-care provider to rule out more serious conditions or to transfer the patient …

Midline Neck Mass

Urgent message: Swelling of the neck is a common problem seen in the urgent care setting. Etiologies range from infectious to lymphatic to malignant. If serious conditions are not diagnosed and treated in a timely manner, complications may lead to airway compromise, sepsis, or even death. How this article helps you: alerts you to uncommon presentations of neck masses. Introdution Swelling in various areas of the neck is frequently seen in urgent care centers. Most …

Nonspecific Numbness and Tingling

Urgent message: Though the cause of nonspecific numbness and tingling will often be benign, serious illnesses should be included in the differential diagnosis. Introduction Many patients at urgent care centers present with numbness and tingling. The symptoms can be caused by variety of underlying benign or potentially malignant pathologies. The medical history and physical examination play a central role in the determination of the cause of numbness. Numbness that is limited to a part of a limb suggests mononeuropathy, whereas numbness that involves most …

Poisoning of a Child Because of an Older Sibling’s Habit

Urgent message: Be aware of new fads and habits that are growing in popularity. Some of them can result in life-threatening symptoms and serious permanent health consequences. Introduction Vomiting is a common presentation in the urgent care setting, especially in the pediatric population. With children, health-care providers must start with a comprehensive differential diagnosis because of the difficulty in obtaining accurate information directly from the patient. The medical history, often presented by the parent, must be carefully sorted through for clues to a …

Pelvic Pain, Dysuria, and Back Pain in an Adolescent Female

Urgent message: Adolescent patients present to urgent care facilities with unique needs and diagnoses. It is imperative that those who care for them be familiar with some of these diagnoses and keep in mind the importance of obtaining a full and accurate medical history and performing a thorough physical examination. Introduction Adolescent patients can represent unique challenges for health-care providers. In caring for them, providers must work from a broad differential, including diagnoses common to …

Ocular Arteriovenous Malformation Manifesting as Proptosis

Urgent message: Proptosis may be caused by a variety of vascular, infectious, endocrine, and neoplastic diseases that may threaten vision or cause serious systemic complications or death. Providers should be familiar with causes and work-up, including which findings suggest a need for immediate imaging and consultation. ARMIN GOLLOGLY, MD, BRIAN ZIPSER, MD, WENDY HUANG, MD, FAAO, FAAP, CHRISTOPHER M. FECAROTTA, MD, FAAO, FAAP, FCPP, AND MARK RICHMAN, MD, MPH Introduction This report describes a case of unilateral proptosis due to …

Sore Wrists with Soft-Tissue Hypertonicity and Swelling

Urgent message: It is important for urgent care providers to be able to recognize the lesser-known arthritides as causes of acute joint pain and to recognize their specific manifestations on x-rays. Further work-up is warranted because some of these diseases can be associated with various metabolic disorders. MAY MOHTY, MD, FAAP, FAAUCM, and HAMILTON WHITE, MS4 Introduction The deposition of calcium pyrophosphate dihydrate crystals in and around joints is called CPPD (calcium pyrophosphate dihydrate deposition) disease. This condition manifests in a variety …

Shin Pain

Urgent message: Lower extremity injuries are very common in adolescent athletes. Urgent care providers must remember that shin pain is not always simply shin splints. CHRISTOPHER TANGEN, DO, and RYAN SHILIAN, DO Also known as medial tibial stress syndrome, shin splints are described as the painful inflammation of the tibial periosteum, which is generally caused by repetitive physical activity.1 Repetitive injuries can cause incomplete fractures, or microfractures, of the tibia. These tibial stress reactions can predispose the bone to acute fractures. Case Presentation …