Glass in Foot

Case The patient is an 8-year-old boy with pain in the right foot for the last several hours. He refuses to walk on the foot. There is no reported injury. On physical exam, you find there is a normal appearance to the foot (no erythema,  swelling). However, there is pain with palpation over the plantar aspect of the mid aspect of the right foot. View the image taken (Figure 1) and consider what your diagnosis …

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Lateral Humeral Condyle Fracture

Case A 14-year-old boy presents to urgent care complaining of lateral right elbow pain that began after a fall on the playground yesterday, in which he landed on his outstretched hand. He has no significant medical or surgical history. The elbow pain is worse with range of motion. He denies any wrist or shoulder pain, and there is no head trauma. There are no paresthesias to the hand or arm. View the images taken (Figures …

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Dry Cough in a 19-Year-Old Male

Case A 19-year-old man presents to urgent care with a 5-day history of a dry cough. He says he has “felt warm” but didn’t think to check his temperature. He also complains that he has been weak, with a decreased appetite. He notes that his girlfriend had an upper respiratory infection a couple of weeks ago, but other than that he’s had no exposure to anyone who’s been sick. He has not traveled anywhere recently, …

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Fever, Conjunctival Injection, and a Facial Papule

Fever, Conjunctival Injection, and a Facial Papule

Case A mother brings her 10-year-old son to an urgent care center with a fever, conjunctival injection, and pharyngitis. She points out a smooth papule on his face that developed over the last few days. She says that he played with some kittens at a friend’s house about a week earlier, and she wonders if maybe he is extremely allergic to cats, because he has been rubbing his eyes ever since. View the image taken …

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Hip Pain in an 80-Year-Old Woman

Hip Pain in an 80-Year-Old Woman

Case An 80-year-old woman presents to an urgent care center with left hip pain that she has had for 4 years but that has worsened in the last week. She reports that before the pain worsened, she had gone on a long walk with her grandson. The pain is worse with movement through the range of motion. She has taken ibuprofen, but it did not reduce her pain. She says that she has not had …

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Knee Pain in a 78-Year-Old

Case A 78-year-old man presents to an urgent care center with bilateral knee pain that he has had for 1 week. The pain is worse in his right knee and is worse with ambulation. He says that he has not experienced any recent trauma, but he does note that he has been helping his son move into an apartment. He reports no fever, dizziness, chest pain, or shortness of breath. He has hypertension, for which …

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Young Football Player with Sudden Chest Pain

Case A 20-year-old previously healthy man presents with sudden onset of substernal chest pressure after completing football practice. His chest pain is nonradiating, nonreproducible, and nonpositional. He does not have associated palpitations, dyspnea, or diaphoresis. He reports that he has not had recent upper respiratory tract infections or contact with ill people. He does not have a history of using alcohol, tobacco, or illicit drugs. He has no family history of sudden cardiac death or …

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Pain in the Hand After Punching a Wall

Pain in the Hand After Punching a Wall

Case An 18-year-old man presents to an urgent care center with pain at the distal aspect of the metacarpal bone of the little finger. The pain began 2 hours earlier, after he punched a wall. He has pain with range of motion and a minimal amount of numbness in the finger. He reports that he has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.

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A Fall from a Roof by an Adult

Case A 29-year-old woman presents to an urgent care center after a fall from the roof of her house, where she was cleaning the gutters. She reports that her right heel began hurting intensely immediately after the fall and that the pain worsened in the time it took for a family member to get her to the center. She cannot bear weight on her right leg. She mentions that she is a runner who often takes part in …

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Ten-Day Dry Cough in a 36-Year-Old Man

Case A 36-year-old man presents to an urgent care center with a dry cough that he has had for the preceding 10 days. He has mild dyspnea. He has no rhinorrhea, fever, chest pain, blood in the urine or stool, or lower-extremity pain or swelling. He has no history of previous illnesses. He smokes cigarettes, occasionally drinks alcohol, and has a remote history of intravenous drug use. View the image taken (Figure 1) and consider …

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