A 24-Year-Old Female with a New, Unexplained ‘Rash’ on Her Leg

The patient is a 24-year-old woman who presents to urgent care with several linear lesions on her leg, accompanied by a burning skin sensation which developed days after starting a job as an outdoor bartender at a local beach resort. View the image taken 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 Pregnant Woman with Upper Right Quadrant Pain

A Pregnant Woman with Upper Right Quadrant Pain

Urgent message: The presentation of a pregnant woman to urgent care is often associated with consternation for both the patient and the provider. When a pregnant patient presents to urgent care with right upper quadrant pain, initial bedside ultrasound screening for gall bladder disease can facilitate initial interventions as well as expedite follow up care. CASE PRESENTATION  History A 25-year-old nulliparous female 24 weeks pregnant presented to urgent care 4 hours after onset of nausea, …

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Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Chest X-Ray Findings in 636 Ambulatory Patients with COVID-19 Presenting to an Urgent Care Center: A Normal Chest X-Ray Is no Guarantee

Michael B. Weinstock, MD, Ana Echenique, MD, DABR, Joshua W. Russell, MD, MSc, FACEP, Ari Leib, MD, Jordan A. Miller, DO, David J. Cohen, MD, Stephen Waite, MD, Allen Frye, NP, and Frank A. Illuzzi, MD, FACEP Abstract Background/Objective Patients with COVID-19 commonly present to Urgent Care (UC) centers. Our primary objective was to determine what percentage of UC patients with confirmed COVID-19 had normal vs abnormal chest x-rays (CXR). Secondarily, we aim to describe …

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This Was Their Finest Hour

1940 was a particularly hopeless year in Great Britain. Having easily conquered France and signed a temporary treaty with the USSR, Adolf Hitler turned his full attention towards the conquest of the United Kingdom. As the Battle of Britain commenced, Prime Minister Winston Churchill, against this bleak backdrop, memorably addressed his people, and the world: “…if we fail, then the whole world…including all that we have known and cared for, will sink into the abyss …

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Conducting Preparticipation Sports Physicals in the Urgent Care Center

Conducting Preparticipation Sports Physicals in the Urgent Care Center

Urgent message: Youth athletic programs are ubiquitous in the United States, with leagues requiring players to have a physical exam before they’re allowed to take part. Ensuring your urgent care center is ready to be a “go to” resource for a thorough work-up increases young athletes’ chances for a safe experience and bolsters your position as a valued community health resource. INTRODUCTION Millions of juveniles participate in organized athletics the world over every year. In …

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Management of Lisfranc Dislocation in the Urgent Care Center

Management of Lisfranc Dislocation in the Urgent Care Center

Urgent message: Lisfranc dislocations are relatively rare, but should be on the urgent care provider’s radar in patients who refuse to bear weight and who have significant midfoot pain and swelling after an acute trauma causing hyperplantarflexion of the foot. Introduction The tarsometatarsal (TMT), or Lisfranc, joint complex is the attachment between the forefoot and midfoot. This joint is the keystone to normal foot function and is thus critical for normal gait.1 Jacques L. Lisfranc …

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A 22-Year-Old Female with Frequent Nosebleeds and Abnormalities on Her Lips and Tongue

A 22-Year-Old Female with Frequent Nosebleeds and Abnormalities on Her Lips and Tongue

The patient is a 22-year-old woman who presents complaining of frequent nosebleeds. On exam, you note bright red macules and spider veins on her lips and tongue. They disappear briefly when you press on them. Review the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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Abstracts in Urgent Care May 2020

General Statistics of COVID-19 Clinical Characteristics of COVID-19 Characteristics of Healthcare Workers Infected with COVID-19 A Simple Algorithm for Treatment of Nonpurulent Infections Topical Lidocaine for Oral Ulcers in Children Walking Boot vs Rigid Cast in Achilles Tendon Rupture General Statistics of COVID-19 Key Point: The majority of patients with COVID-19 have mild symptoms; however, those with critical disease have a mortality rate of 49%. Citation: Wu Z, McGoogan JM. Characteristics of and important lessons …

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A 55-Year-Old Female with Hip Pain

A 55-Year-Old Female with Hip Pain

The patient is a 55-year-old woman who presents with what she calls minor pain in her left hip. She denies any trauma, and insists the pain “isn’t that bad.” She’s only seeking care as a precautionary measure in advance of a family camping trip. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

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