Journal of Urgent Care Medicine

Reoccurring Metatarsophalangeal Joint Pain

Urgent message: Acute or chronic hallux pain is a common complaint in urgent care. Due to the structure, several diagnoses can have similar presentation on history and exam. With this discussion, we examine a sesamoid stress injury. Sergio P. Ramoa, MD, MS INTRODUCTION The tibial (medial) and fibular (lateral) sesamoids are contained within the flexor hallucis brevis tendons along the metatarsal head.1 They have several roles such as absorbing weight, helping glide and reducing friction …

Atypical Skin Abscess Caused by Nontuberculous Mycobacterium

Urgent message: Cutaneous abscesses are common presentations in urgent care. While either methicillin-sensitive or methicillin-resistant Staphylococcus aureus accounts for up to 75% of skin abscesses, atypical organisms such as nontuberculous mycobacteria (NTMB) can also lead to abscess formation. Urgent care providers should be aware that the clinical presentation may be atypical and require specialized treatment. Rachel Hughes, MD and Erik Butler, DO CASE PRESENTATION A 26-year-old female with no known past medical history other than …

Similar to Past Flare Ups Pulmonary Eosinophilia: Putting the Pieces Together

Urgent message: Pulmonary eosinophilia is a generic term for a heterogeneous group of disorders that result in increased eosinophils within the pulmonary parenchyma. Ultimately, the patient here was treated with an extended course of glucocorticoids to treat his chronic eosinophilic pneumonia until he could follow up with his hematologist/pulmonologist. CASE PRESENTATION The patient is a 29-year-old male with history of pulmonary eosinophilia, degenerative disc disease, and asthma who presents to an urgent care center with …

Case Report: Reoccurring Metatarsophalangeal Joint Pain

Breakthrough COVID Infection in a Vaccinated person from a Possible Vaccinated Exposure

Sergio Ramoa MD, MS Urgent Message: With variant COVID-19 mutations, incomplete herd immunity, and less restrictive government regulatory statues, it is important to remain vigilant with continued testing and prevention even with a full vaccinated history. Introduction In the United States, cases of COVID-19 have passed 32,000,000 and 570,000 for deaths. 141,000,000 cases and 3,000,000 deaths have afflicted the world. Approximately 9.6% of infected individuals are hospitalized and a majority have mild to moderate symptoms.1 …

An Atypical Presentation of Thyroid Storm: A Stark Yet Potentially Lethal Diagnosis

Urgent message: Unmanaged hyperthyroidism can cause any number of acute conditions that would drive a patient to visit an urgent care center. Further, thyroid storm can mimic several life-threatening events. Early recognition of the correct diagnosis is essential to raising the likelihood of a positive outcome—and protecting the patient from self-harm. Amrita Mahajan, BA and Lindsey Fish, MD INTRODUCTION Thyroid storm is a rare, life-threatening complication of thyrotoxicosis, a condition caused by excess thyroid hormone. …

A Hand Wound Caused by a Pressure Washer

Urgent message: Injuries caused by pressure washers often require debridement or, in severe cases, amputation. Immediate assessment and appropriate management, where feasible, can preclude the need for surgical intervention while effecting a positive outcome. Ellen Hancock, MD; Julie Park; MD, FACS; and Kendall Wermine INTRODUCTION Pressure washer injuries tend to involve the lower extremities and abdomen and usually require a form of surgical intervention such as debridement of tissue and, in severe cases, amputation.1-4 The …

A 38-Year-Old Man with Chest Pain

Urgent message: When a relatively young patient presents to urgent care with chest pain, there may or may not be a “typical” cause. Prompt evaluation and accurate assessment of risk factors are essential to efficient care and, often, the patient’s survival. Max Palatnik, MD Case Presentation A 35-year-old male presented at 21:59 with a chief complaint of chest pain; at 22:03, we noted the following: Temp: 98.9 Pulse: 103 Resp: 16 Syst: 122 Diast: 69 …

Lumbar Hernia: An Unusual Cause of Back Pain

Urgent message: Back pain is a common complaint in the urgent care setting. Common causes of musculoskeletal back pain include overuse and work-related injury. Other causes can include disc herniation, metastasis, osteoporosis, arthritis, spinal stenosis, and nephrolithiasis. Crystal N. Bharat MD, Ronald Dvorkin, MD, and Glenn G. Gray MD Case Presentation A 65-year-old female complained of 1 day of low back pain radiating to her left flank, which was aggravated with movement. Symptoms began while …

Intermittent Abdominal Pain and Vomiting in a Teenager: One More Urgent Cause to Consider

Urgent message: Superior mesenteric artery syndrome should be included in the differential diagnosis in children with abdominal pain and weight loss with rapid increase in linear growth. Ralph Mohty, MS3, and Michael Esmay, MD Introduction Abdominal pain is one of the most common complaints in childhood. A minor self-limited condition such as constipation or viral gastroenteritis is usually the cause, but more serious conditions need further evaluation and management.1 Chronic abdominal pain is a term …