Practice Management
A 47-year-old man presents to urgent care after trying out a new cardio boxing class at the local recreation center. He indicates that his right hand has been hurting ever since he hit a punching bag this morning, and the pain has been getting worse. X-rays are ordered, both anterior posterior (AP) and oblique views. Review the images and consider what your diagnosis and next steps would be. Resolution of the case is described on …
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A 52-year-old male presents to urgent care complaining of palpitations. 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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Urgent Message: Progressive diaphyseal dysplasia, also known as Camurati-Engelmann disease, is a rare genetic disease that predominantly affects the bones. Clinicians who understand the manifestations of this disorder are better equipped to ensure appropriate management of disease flares and coordinate specialist follow-up. Swetha Gogu, DO, MPH; Sudhir Gogu, DO, PhD, MBA Citation: Gogu S, Gogu S. Progressive Diaphyseal Dysplasia: A Case Report. J Urgent Care Med. 2024; 18 (11): 34-37 Abstract Introduction: Camurati-Engelmann disease (CED), …
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A 64-year-old man presents to urgent care with a lesion on his face for the last 2 months. On examination, a shiny, eroded, blue-black nodule was seen on his right cheek. He is a postal worker. Histopathology examination showed aggregates of melanin and melanocytes within sheets of basaloid keratinocytes with peripheral palisading and surrounding clefts within a fibromyxoid stroma containing melanophages. View the image above and consider what your diagnosis and next steps would be. …
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A 29-year-old man presents to urgent care complaining of chronic right hip pain with movement and exercise. He’s an avid mountain climber and used to play sports in college. Review the images 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 70-year-old male with a history of atrial fibrillation presents to urgent care for 1 week of fatigue and edema of the lower extremities and face. 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. Case presented by Joe Stockhausen, MD
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A 56-year-old woman presents to urgent care for a rash that developed on her hands, ears, and nose over the last couple of months. She has a recent diagnosis of esophageal cancer. On examination, hyperkeratotic plaques were seen on the palm and fingers, and scaly papules were seen on her helices and nose. Her nails displayed subungual hyperkeratosis, onychodystrophy, and onycholysis along with erythema and edema on her nail folds. View the image below and …
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Urgent Message: Acute coronary syndromes (ACS), including ST-elevation myocardial infarction (STEMI), may present with predominant back pain or other non-chest-pain symptoms. Additionally, electrocardiogram findings in cases of coronary occlusion may not always meet STEMI criteria. It is important to include myocardial ischemia and ACS in the differential for back pain presentations, especially when the pain is not reproducible. Sarah Mannon OMS-3; Lauren Schuermann OMS-3; Michael B. Weinstock, MD Citation: Mannon S, Schuermann L, Weinstock M. …
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Use of NEXUS II Clinical Decision Tool for Blunt Head Injuries in Elderly Patients Take Home Point: Older patients with blunt head-injury are at high risk of sustaining serious intracranial injuries even with low-risk mechanisms of injury, such as ground-level falls. Citation: Mower W, Akie T, Morizadeh N, et. al. Blunt Head Injury in the Elderly: Analysis of the NEXUS II Injury Cohort. Ann Emerg Med. 2024 May;83(5):457-466. doi: 10.1016/j.annemergmed.2024.01.003 Relevance: Older adults are known …
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Urgent Message: Fast trackmodels aim to improve patient throughput metrics for low-acuity patients. In this quality improvement project, a process for fast track in the pediatric urgent care significantly improved patient flow. Hayley L. Ross, MD; Sandra P. Spencer, MD; Traci Ertle, MSN, RN, CPEN; Anthony Watkins, MSN, RN, NE-BC; Mark Feldman, MD; Derrek Massanari, MD, MPH; Bernadette Johnson, MD; Alexandria J. Wiersma, MD Citation: Ross HL, Spencer SP, Ertle T, Watkins A, Feldman M, …
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