Journal of Urgent Care Medicine

A 27-Year-Old Male with Chest Pain and No Reported Medical History

Chamber Abnormalities: Pathologic or Not? A 27-year-old male with no reported medical history presents with chest pain. He relays several weeks of intermittent symptoms which started after lifting heavy boxes. The pain is sharp, located in the mid-chest and is otherwise non-tearing, non-pleuritic, non-positional and not associated with exertion. On examination, the patient is in no acute distress, and appears lean without cachexia or wasting. The pain is reproduced with shoulder extension. It resolves with …

A 68-Year-Old Woman with a Rash of Several Weeks’ Duration

The patient is a 68-year-old woman who presents with a rash she says developed on her trunk over a span of several weeks. On examination, there were multiple confluent, orange-red plaques on the trunk and arms with “islands of sparing” within them. The rash had a primarily truncal distribution and was pruritic. She was feeling well otherwise. View the image and consider what your next steps and diagnosis would be. Resolution of the case is …

A 15-Year-Old Boy with a Painful Elbow After a Baseball Game

The patient is a 15-year-old boy who presents to urgent care with a painful medial right elbow he and his parents attribute to pitching in a baseball game earlier in the day. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 36-Year-Old Male with Sudden-Onset Substernal Chest Pain

The patient is a 36-year-old male with a history of tobacco and alcohol use who presents to urgent care with sudden-onset substernal chest pain and shortness of breath that began 1 hour prior to arrival. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 43-Year-Old Man with a Painful, Purulent Finger

The patient is a 43-year-old male who presents with a painful collection of pus near his fingernail. He reported that it had developed over the past day. On examination, a large, yellow-green superficial pus collection was seen at the proximal nail fold with surrounding erythema and edema. The patient mentioned that he had a home renovation business and that it was common for him to experience mild injuries such as splinters on his hands. The …

A 47-Year-Old with Pain After Twisting His Ankle

The patient is a 47-year-old male who presents with a primary complaint of right ankle pain after a pick-up game of basketball. He reports he twisted his ankle when he landed on another player’s foot. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 6-Year-Old Boy with a Lesion on His Ear

The patient, a 6-year-old boy, presented to a pediatric urgent care center for a well-child visit. In the exam room, the father pointed out a red lesion on the helical rim of the patient’s ear. The papule was smooth and well-defined and didn’t seem to bother the boy. The father reports that he and the boy’s mother have grown concerned as they’ve noticed it develop over several months. View the image and consider what your …

A 65-Year-Old Man with Shortness of Breath and a History of Heart Failure

A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …

A 75-Year-Old with Chest Pressure

The patient is a 75-year-old male who presents with a primary complaint of pressure in his chest. He denies chest pain, dizziness, or “anything like a heart attack.” View the x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 7-Year-Old Boy with Scaly Red-Brown Papules on His Trunk

A 7-year-old boy is brought to your urgent care center by his mother because she’s concerned about a rash of scaly papules on his trunk, some of which had crusted or healed. A few of the lesions are hemorrhagic. She notes that they appeared a few days ago, accompanied by a mild fever. She dismissed the possibility that the source could be chickenpox because her son had been vaccinated. The boy reports that the papules …