Journal of Urgent Care Medicine

Ludwig’s Angina

Urgent message: Thoroughly evaluate patients who complain of dental or oral pain. CHRISTOPHER MCKENNA and JOHN SHUFELDT, MD, JD, MBA, FACEP Ludwig’s angina is a serious and potentially life-threatening connective tissue infection found on the floor of the mouth and in the deep neck spaces. More specifically, it is a bilateral infection of the submandibular space. The two compartments affected are the sublingual space and the submylohyoid space.1 This condition usually presents in individuals who …

Infectious versus Inflammatory Flexor Tenosynovitis: A Little, Big Problem

Urgent message: Infectious flexor tenosynovitis is an orthopedic emergency that can cause long-lasting disability through tendon necrosis and permanent digital contracture if unrecognized or mismanaged. MARY A. LANE, MD Flexor tenosynovitis is an inflammation of the tendon sheath that can be caused by either introduction of infection or various inflammatory conditions ranging from autoimmune arthropathies to crystal joint depositions. Flexor tenosynovitis caused by infection is an orthopedic emergency. It can cause long-lasting disability through tendon …

October 2012

September 2012

Abdominal Pain of Unusual Origin in a Teen

Urgent message: Always be mindful of the ‘zebra’ in a stampede of ‘horses’ in the differential diagnosis. ELISABETH L. SCHEUFELE, MD, MS, FAAP Case Presentation J.H. is a 19-year-old Hispanic male presenting with abdominal pain and shortness of breath for the last 4 days. He had visited the urgent care clinic about 2 days before with similar symptoms and was discharged with a diagnosis of muscle strain. J.H. returned with persistent symptoms and he indicates …

High-Risk Conditions Presenting as Back Pain (Part 4)

Urgent message: Back pain with incontinence and focal neurological changes are red flags for serious conditions. ERICA MARSHBURN, BS, BA, and JOHN SHUFELDT, MD, JD, MBA, FACEP Low back pain is a common presentation in the urgent care setting and it is important for providers to be aware of signs and symptoms that could indicate a more serious condition than nonspecific muscular pain. Be sure to make a thorough evaluation of your patients and pay …

July/August 2012

June 2012

Drug Toxicity Following Trip to the Local Head Shop

Urgent message: Thorough work-up is mandatory for patients with mild symptoms from recent use of “bath salts” because of the potential for multi-systems failure. JOHN K. GRANDY BS, MS, RPA-C Case Presentation A 19-year-old male is brought to an urgent care clinic by his mother, who states that her son and his friends took “Molly Mosquito Caps” 2 days ago that were purchased from a local head shop. The patient and his friends all experienced …

The Role of Urgent Care Centers in Regional Acute Coronary Syndrome Care

Urgent message: Patients with chest pain/acute coronary syndrome often present in outpatient medical settings—including urgent care centers—not designed to treat life-threatening conditions. Exclusive new data suggest that urgent care centers need to be integrated into pre-hospital cardiovascular care pathways. JASON T. WEINGART, MD, THOMAS P. CARRIGAN, MD, MHSA, LEE RESNICK, MD, DANIEL ELLENBERGER, BS, DANIEL I. SIMON, MD, and RICHARD A. JOSEPHSON, MS, MD Emergency medical services and hospital-based emergency departments (EDs) are typically incorporated …