28-Year-Old With Foot Pain

28-Year-Old With Foot Pain

A 28-year-old woman presents to urgent care after an indoor rock-climbing event. She fell 10 feet from the wall without any safety gear to break the fall. She describes deep pain in her left foot, and she is limping. An exam reveals dorsal and plantar midfoot tenderness and bruising across the dorsal foot. A 3-view x-ray series is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the …

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65-Year-Old With Hypertension

65-Year-Old With Hypertension

A 65-year-old female with a history of hypertension presents with chest pain and dyspnea for 1 day. She denies fever, cough, nausea, vomiting, or abdominal pain. Upon arrival to urgent care, her respiratory rate was 28 breaths per minute, blood pressure 179/102, and oxygen saturation 92% on room air. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on …

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36-Year-Old With Hair Loss

36-Year-Old With Hair Loss

A 36-year-old man presents to urgent care with asymptomatic hair loss that developed on multiple sites of his scalp over the previous 2 months. The hair loss developed in round patches that expanded to involve most of the back of his scalp. His past medical history is notable for hyperthyroidism. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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7-Year-Old With Playground Injury

7-Year-Old With Playground Injury

A 7-year-old boy presents to urgent care with his worried mother after he fell off a swing at daycare. He is complaining of right foot pain and can’t walk on the injured foot. Anterior posterior and oblique foot x-rays are ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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57-Year-Old with Left Foot Pain

57-Year-Old with Left Foot Pain

A 57-year-old man presents to the urgent care with a 3-day history of left foot pain and swelling after walking barefoot on a wooden deck under construction. He recalls feeling a sharp pain in the affected foot at the time but could not see any foreign object. On examination, he has mild erythema, tenderness, and induration over the plantar surface of the midfoot. There is no visible puncture wound or foreign body present. Plain radiographs …

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45-Year-Old With Painful Ankle Lesion

45-Year-Old With Painful Ankle Lesion

A 45-year-old woman presents to urgent care with a painful area that developed on her right ankle 2 weeks prior. The patient had a family history of venous thromboembolism. On examination, a variegated brown patch with a central pink angulated scar and an overlying thick crust on the lateral ankle was seen. There was also unilateral peripheral leg edema. On laboratory examination, anemia, thrombocytopenia and anticardiolipin antibodies were present. View the image and consider what …

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16-Year-Old With Hip Pain

16-Year-Old With Hip Pain

A 16-year-old female presents to urgent care with her mother after soccer practice at school. She says she felt a “pop” in her left hip, immediately followed by posterior hip pain. Walking makes it worse, but resting makes the pain better. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

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65-Year-Old With Finger Growth

65-Year-Old With Finger Growth

A 65-year-old woman presents to urgent care complaining of a growth that developed on her finger 2 months prior. She says it’s not painful or itchy and has not grown since she first noticed it. On examination, a solitary, smooth, pinkish papule with a tiny central crust is seen on her distal interphalangeal joint on her left index finger. The patient has a history of osteoarthritis. View the image below and consider what your diagnosis …

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