Practice Management
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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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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A 68-year-old female presents to urgent care with dyspnea for 2 days. She has a medical history of heart failure. 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 the next page.
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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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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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A 74-year-old woman presents to urgent care with epistaxis, controlled on arrival. She is also complaining of lightheadedness and fatigue that’s been going on for the past 2 weeks. 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.
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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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A 29-year-old man presents to urgent care on a Saturday with pain in his left foot after playing tennis. A series of x-rays is ordered. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Differential Diagnosis Diagnosis The correct diagnosis is an avulsion fracture of the base of the 5th metatarsal. The x-ray shows transverse lucency at the base of …
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A 27-year-old female with history of asthma presents to urgent care on a Friday morning with dyspnea for 1 day. She denies palpitations, syncope, or chest pain. 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 the next page.
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A 16-year-old girl presents to urgent care with complaints of fever, chills, and a diffuse sunburn-like rash that developed over the past day. The patient underwent septoplasty 2 days prior for a deviated septum, and nasal packing was utilized to manage her postoperative bleeding. On examination in urgent care, she was febrile to 104°F (40°C), tachycardic, and hypotensive. Widespread erythematous blanching macules and patches were seen. View the image below and consider what your …
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