Journal of Urgent Care Medicine

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From Disc Herniation: A Case Report

Urgent Message: Abdominal pseudohernia is a rare diagnosis with variable presentation. Urgent care clinicians who are familiar with the condition and its variable presentations can reduce the risk of diagnostic errors and unnecessary or inappropriate diagnostic testing. Berkeley E Prewett, BSA; Stephen V Green, MD; Andrew L Juergens II, MD; Taylor K Ratcliff, MD Citation: Prewett BE, Green SV, Juergens AL, Ratcliff TK. Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From …

Puffy Hand Syndrome: A Case Report

Urgent Message: Incorporating questions regarding the use of intravenous drugs may help ensure the diagnosis of puffy hand syndrome is included in the differential for patients presenting with bilateral hand swelling. Citation: Majeed I, VanDyke K. Puffy Hand Syndrome: A Case Report. J Urgent Care Med. 2024; 19 (2): 25-27 Abstract Introduction: Bilateral hand swelling is a common presentation in a variety of conditions, particularly rheumatological disorders. Urgent care (UC) providers can avoid unnecessary testing …

Recognition and Management of Achenbach Syndrome (Paroxysmal Finger Hematoma)

Urgent Message: By understanding the symptoms of paroxysmal finger hematoma, clinicians can reduce patient anxiety and decrease unnecessary testing, as the condition is generally mild and has a favorable prognosis. Citation: Sanz Martinez E, Kranichfeld WH, Ceballos Y. Achenbach Syndrome: Diagnosis of Paroxysmal Finger Hematoma. J Urgent Care Med. 2024; 19(1): 25-29 Introduction Paroxysmal finger hematoma (PFH), also known as Achenbach syndrome, is a vascular disorder of unknown etiology characterized by subcutaneous bleeding in the …

Progressive Diaphyseal Dysplasia: A Case Report

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), …

Escalating Back Pain Leading to a Diagnosis of ST-Elevation Myocardial Infarction (STEMI) in Urgent Care: A Case Report

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. …

Atypical Chest X-ray Appearance in a Patient with Cough: A Case Report

Urgent Message: The azygos lobe may be apparent on a chest x-ray and is a relatively uncommon, yet benign finding, that is important to distinguish from other etiologies. The azygos lobe is an embryological remnant and is usually incidental in nature. Citation: Richmond C, Mancuso A. Atypical Chest X-ray Appearance in a Patient with Cough: A Case Report. J Urgent Care Med. 2024; 18(10):23-25 Keywords: azygos lobe, normal variant, chest x-ray Abstract Introduction: Recognition of …

Intraoral Angioedema After Olanzapine Overdose: A Case Report

Urgent Message: Patients may present to an urgent care facility with intraoral angioedema, a life-threatening emergency that requires referral to an emergency department in any case with rapid progression or concerns for airway involvement. This case report describes angioedema from olanzapine, an antipsychotic prescription drug. Chantelle Petterson, BDS, Benjamin Fu, MD, BDSc (HONS), MPhil, FRACDS (OMS) Citation: Petterson C, Fu B. Intraoral Angioedema After Olanzapine Overdose: A Case Report. J Urgent Care Med. 2024; 18(9):34-36 …

Isolated Sternal Fractures After Trampoline Falls in Children: A Case Series

Urgent Message: Isolated sternal fractures in children can occur from relatively minor trauma, such as a trampoline fall, and patients can often be managed conservatively. NaShayla Davis, MD; Olabisi Pearse, MD; Swati Mahajan, MD; Marie-Helene Gagnon, MD; Rebecca Burger, MD Citation: Davis N, Pearse O, Mahajan S, Gagnon MH, Burger R. Isolated Sternal Fractures After Trampoline Falls in Children: A Case Series. J Urgent Care Med. 2024; 18(6): 13-16 Key Words: Trampoline, Fall, Fracture, Injury, …

An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism Diagnosis

Francesca Cocchiarale, DO; Alexa Bailey, MS-3; Michael Weinstock, MD Urgent Message: Pulmonary embolism can be frequently missed as a diagnosis because it can present with a variety of signs and symptoms. Understanding clinical decision rules and myriad presentations can help urgent care providers determine when patients benefit from immediate referral to an emergency department. Citation: Cocchiarale F, Bailey A, Weinstock M. An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism …

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