Journal of Urgent Care Medicine

Real-World Validation of Rapid PCR Strep Testing in Urgent Care

Urgent Message: The diagnosis of bacterial pharyngitis is often difficult. Rapid polymerase chain reaction testing has potential to improve diagnostic certainty. Despite high accuracy rates, many urgent care providers continue to seek confirmation by throat culture. Justin Bowles, MD, Supreet Ghumman, MS4 Citation: Bowles J, Ghumman S. Real world validation of rapid PCR strep testing in urgent care. J Urgent Care Med. 2023;18(2):15-21 Key Words: bacterial pharyngitis; PCR testing Abstract Introduction: Point-of-care polymerase chain reaction …

66-Year-Old With Weakness and Dyspnea

A 66-year-old male presents in the urgent care, saying “it’s hard to breathe.” He’s had weakness and dyspnea for one day. The patient has a medical history of diabetes, hypertension, and heart failure. The patient has a pacemaker. 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

Abstracts in Urgent Care November 2023

What Should We Do with the Nail? Nailbed Repair in Children Take Home Point: After nail bed repair, discarding the fingernail was associated with similar rates of infection and similar cosmetic outcomes compared to replacement of the fingernail. Citation: Jain A, Grieg A, Jones A, et al. Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial. BJS, 2023, 110, 432–438 https://doi.org/10.1093/bjs/znad031 Relevance: Procedures for nail bed …

Detection and Management of Urinary Calculi in the Urgent Care Setting

Andrew Alaya MD MSc Urgent Message: Abdominal pain is a common urgent care complaint that may result from a variety of benign to life-threatening etiologies, which can pose diagnostic and therapeutic difficulty for the clinician. Ureteral calculi are able to be diagnosed and managed in the urgent care setting. Citation: Alaya A. Detection and Management of Urinary Calculi in the Urgent Care Setting. J Urgent Care Med. 2023;18(2); 31-38 Introduction/Epidemiology Formation of calculi in the …

52-Year-Old With a Lateral Nasal Growth

A 52-year-old man presents to urgent care for a new growth on his nose. On examination, a smooth, faint pink papule with overlying scant telangiectasias was seen at the lateral nasal sidewall. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Diabetic Ketoacidosis Due to Intra-articular Steroids: A Case Report

Tracey Quail Davidoff, MD, FCUCM Urgent Message: Corticosteroid use is common, and patients receiving corticosteroids of any type are at risk for hyperglycemia and possible ketoacidosis. Citation: Quail Davidoff T. Diabetic Ketoacidosis Due to Intra-articular Steroids: A Case Report. J Urgent Care Med. 2023;18(2):39-40 Key Words: polyuria, polydipsia, glucosuria, ketoacidosis, corticosteroids, intra-articular corticosteroids. Abstract A 63-year-old male presents to urgent care with a self-diagnosis of urinary tract infection (UTI). The patient had been experiencing urinary …

What Happens If We Do Nothing?

Joshua Russell, MD, MSc, FCUCM, FACEP In its most modern form, medicine revolves around action. We are trained as clinicians to assess, diagnose, and intervene, but it’s the intervention part that patients expect most. This is especially true in urgent care (UC), where patients usually present in anticipation of some swift action for whatever is bothering them. I recently saw a healthy, middle-aged man in our clinic who was complaining of some mild chest pain. …

46-Year-Old Male With Severe, Worsening Chest Pain

A 46-year-old man with a history of hypertension presented in an urgent care center saying he’s had chest pain for 2 days. He also said the pain has been worsening each day, and today it is severe. He denies nausea, vomiting, or shortness of breath. On exam, he appears uncomfortable but has normal vital signs. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is …

8-Year-Old With Facial Lesions

An 8-year-old-boy presented to urgent care with his father for evaluation of 3 weeks of painless facial lesions. The patient had a history of atopic dermatitis and denies systemic symptoms. On examination, he appeared well. A cluster of umbilicated papules were seen over his right cheek. View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

4-Year-Old With Right-Sided Pelvic Pain

On a Friday afternoon, a worried mother brings her 4-year-old daughter to the urgent care. She says the girl is complaining that her “side hurts.” The mother can’t recall any recent falls or injuries. Review the image of the anterior to posterior (AP) pelvis taken upon presentation and consider possible diagnoses and next steps you would recommend to the family.