Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
Read MoreDull, Constant Back Pain After a Fall: Abdominal Aortic Aneurysm (AAA)
Case A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.” Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, …
Read MoreClavicular Pain in a 23-Year-Old
Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …
Read MoreHeel and Ankle Pain in an Adult After a Jump from a Second-Floor Window
A 38-year-old man presents to an urgent care center and reports pain in his right heel and ankle that he describes as severe enough that he cannot walk on the foot. He says that the pain began the previous evening when he landed on the group after jumping out of a second-floor window on a dare. He has some minimal paresthesia, but he has no fever, vomiting, head trauma, head or neck pain, or chest …
Read MoreHip Pain in an Adult After a Fall
A 67-year-old woman presents to an urgent care center after 12 hours of pain in her right hip that began after she slipped in her kitchen and fell onto that hip. She reports that the pain is constant and worsens with walking. She has not experienced numbness in the hip, and she reports no other injuries. She has not sustained any head trauma, and she has no head or neck pain. View the image taken …
Read MoreWrist Pain in an Adult After a Fall
A 62-year-old woman presents with left wrist pain that began after she fell onto her outstretched left hand earlier in the morning while walking her dog. She has wrist pain throughout the range of motion, as well as some pain in her hand. She sustained no injuries to her head or neck, and she has no head pain, neck pain, chest pain, or shortness of breath.
Read MoreShoulder Pain in a 62-Year-Old After a Fall
A 62-year-old man presents with right shoulder pain that began the previous evening after he fell in his garage. The pain is worse with movement through the range of motion. He has no pain in the elbow and says that he has no head pain or head injury. His social history reveals that he is a smoker and drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreShoulder Injury During Football Game
An 11-year-old boy presents with pain over the right clavicle that developed the previous day while he was playing football and another player fell on him. He has pain with range of motion of the right shoulder as well as with movement of the torso. He has no shortness of breath, chest pain, dizziness, or numbness of the arm. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: December, 2015
Case A 56-year-old woman presents after a fall onto her outstretched hand. She has pain with range of motion of the wrist. She has no associated numbness or weakness and reports no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreClinical Challenge: November, 2015
Case A 56-year-old woman presents to an urgent care center with severe ankle pain after stepping off a curb. The physician obtains a radiograph of her ankle. View the image taken (Figure 1) and consider what your diagnosis would be. Resolution of the case is described on the next page.
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