Urgent message: When a child presents with periorbital cellulitis with no obvious cause, checking for intranasal foreign body, such as a button battery, is of paramount importance. Serious complications can be avoided if the foreign body is removed in a timely manner. MAY MOHTY, MD, FAAP, FAAUCM, and JACOB ANDERSON, DO Preseptal cellulitis, also known as periorbital cellulitis, is a relatively common diagnosis in the pediatric population. It is defined as infection of the space …
Read MoreEpiploic Appendagitis
Urgent message: Because pain in the lower abdomen is a symptom that can indicate many diseases, including acute appendicitis and acute diverticulitis, it is easy to misdiagnose epiploic appendagitis (EA). Thus, it is important that urgent care practitioners be able to distinguish EA from many other entities, especially because surgery presents the risk of complications. MAY MOHTY, MD, FAAP, FAAUCM, and ANDREW WANG, MS-3 An epiploic appendage is a fat-filled sac (1–2 cm thick and …
Read MoreMay 2015
Aortic Dissection
Urgent message: Although chest pain in young adults is often benign, it is important to realize that emergency cases can sometimes be disguised as normal examination findings in adults. ZANA ALATTAR and JOHN SHUFELDT, MD, JD, MBA, FACEP This case demonstrates the importance of considering and ruling out rare cases of aortic dissection in patients with chest pain. We describe a case illustrating the approach to the management and work-up of chest pain in young …
Read MoreApril 2015
Fracture of the Penis with Urethral Rupture
Urgent message: Failure to diagnose and, if necessary, repair penile fracture can result in devastating consequences such as stricture, fistula, and long-term voiding difficulty. TAYT ELLISON, MS-3, SHAILENDRA SAXENA, MD, PhD, LAURA KLUG, PharmD, and SANJEEV SHARMA, MD Although penile trauma is not a common presentation in the urgent care setting, it is under-reported because of embarrassment, as are other injuries related to sexual activity. The urgent care clinician should be prepared to evaluate these …
Read MoreMarch 2015
Serious Pathology Masquerading as Chronic Back Pain
Urgent message: Do not be fooled by the diagnosis made by clinicians before you. Many seemingly benign symptoms can be harbingers of more serious pathology. JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP Chronic back pain is a common presentation in both the urgent care and emergency department (ED) settings. Care-on-demand providers often find themselves deciding how extensive a workup to do for a patient with acute-on-chronic back pain. After a patient has …
Read More