Journal of Urgent Care Medicine

An Unexpected Cause of Amenorrhea

Urgent message: The simplest explanation for a mundane symptom may not always reflect the correct diagnosis. Urgent care providers should consider all the possibilities in order to reach the correct conclusion as early as possible, or risk missing a more serious underlying diagnosis. Introduction Sometimes a simple complaint results in a common diagnosis, but other times a rare diagnosis will be discovered. The following case illustrates the importance of considering a wide differential and obtaining …

An Uncommon Mechanism for Work-Related Total Achilles Tendon Rupture

Urgent message: This is a really big deal to urgent care clinicians and operators. Introduction Achilles tendon (AT) ruptures account for approximately 40% of all operative tendon repairs.1,2 With 18 ruptures per 100,000 people, it is the most frequently ruptured tendon—and the incidence of AT ruptures has been steadily increasing over the past few decades.1–4 Typical patients include athletic males between the ages of 30 and 50.3 Because the AT is the strongest, yet most …

A Rare but Insidious Cause of Abdominal Pain

Urgent message: Recognizing the need for workup and referral in patients, even if their symptoms are relatively common, is crucial for optimal outcomes Introduction Abdominal symptoms can be attributed to a wide array of causes. When etiology is not immediately apparent, searching for signs and symptoms the patient may not have reported—or even be aware of—may be the first steps toward timely diagnosis and treatment. In this case, the abdominal symptoms were ultimately due to …

Initially Missed Diagnosis of Quadriceps Partial Tendon Tear

Urgent message: Quadriceps tendon tears are misdiagnosed frequently, leaving patients at excessive risk for long-term disability. Early identification and immediate referral for further care—often, surgery—is necessary for optimal outcomes. Low-riding patella (patella baja) commonly seen in complete tendon tears. (Photo courtesy of Wikimedia Commons.) Introduction Musculoskeletal injuries are among of the most common problems seen in the urgent care setting. Quadriceps tendon tears are uncommon injuries, with an incidence of approximately 1.4/100,000 per year. Consequently, …

November 2016

Midline Neck Mass

Urgent message: Swelling of the neck is a common problem seen in the urgent care setting. Etiologies range from infectious to lymphatic to malignant. If serious conditions are not diagnosed and treated in a timely manner, complications may lead to airway compromise, sepsis, or even death. How this article helps you: alerts you to uncommon presentations of neck masses. Introdution Swelling in various areas of the neck is frequently seen in urgent care centers. Most …

Rocky Mountain Spotted Fever: Dermatologic Manifestation of a Life- Threatening, Systemic Disease

Urgent message: Obtaining a detailed medical history is paramount for the early detection and treatment of Rocky Mountain spotted fever. Failure to acquire adequate patient information can lead to misdiagnosis and delayed treatment of this potentially life-threatening disease. WHITNEY CRAMER, PA-C Many dermatologic conditions such as rashes and eczema are encountered by urgent care providers on a daily basis. Often these conditions are diagnosed as contact dermatitis or are misdiagnosed, or the patient is referred …

Palatine Mass: Physiologic or Pathologic?

Urgent message: Urgent care physicians often encounter patients with masses in the mouth. If they are aware of the existence of toripalatinus and know how to treat them, they can reassure patients who may mistake this benign, congenital bony growth for cancer. JOSHUA WILSON, MS3, and SHAILENDRA SAXENA, MD, PhD Introduction Urgent care and primary-care physicians often must evaluate masses within the mouth. These masses commonly originate from the submandibular or sublingual gland, but a …

September 2015

Soft-Tissue Infection Due to Vibrio parahaemolyticus and Aeromonas hydrophila

Urgent message: Failure to recognize and treat the early development of skin and soft-tissue infection from a stingray envenomation may result in significant tissue necrosis and systemic inflammatory response syndrome. WILLIAM A. WOOLERY, DO, PhD, MS, MBA, FACOFP Stingray injuries to humans are very common but rarely fatal. Approximately 2000 cases are reported annually in the United States.1–3 At my rural hospital on the west coast of Florida, we see an average of 45 such …