Journal of Urgent Care Medicine

16-Year-Old With Rash After Septoplasty

A 16-year-old girl presents to urgent care with complaints of fever, chills, and a diffuse sunburn-like rash that developed over the past day. The patient underwent septoplasty 2 days prior for a deviated septum, and nasal packing was utilized to manage her postoperative bleeding. On examination in urgent care, she was febrile to 104°F (40°C), tachycardic, and hypotensive. Widespread erythematous blanching macules and patches were seen. View the image below and consider what your …

55-Year-Old With Wrist Pain

A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

35-Year-Old With ESRD

A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

15-Year-Old With Fever

A 15-year-old girl presents to urgent care with complaints of fever, arthralgia, abdominal pain, and a widespread rash that developed over the last 2 days. The patient says that the pain in her knees is severe and debilitating. On examination, the patient has a temperature of 100.3°F (37.9°C) as well as maroon and violaceous, purpuric papules and plaques on the legs, buttocks, and face. Laboratory examination shows elevated erythrocyte sedimentation rate and C-reactive protein, proteinuria, …

30-Year-Old With Back Pain

A 30-year-old woman presents to urgent care with pain in her lower back and pelvis. She denies any injury or accident that might be causing her pain. She has just returned to full-time work after having a baby. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

59-Year-Old With History Of Hypertension

A 59-year-old male with a past medical history of hypertension presents with dyspnea and pleuritic chest pain in urgent care, and an ECG is obtained. View the ECG captured below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

25-Year-Old With Hand Rash

A 25-year-old man undergoing chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone for acute lymphoblastic leukemia arrives in urgent care because he’s developed a painful, burning palmar eruption. On examination, tender, shiny, erythematous papules and plaques were seen on the palms and fingers as well as the soles of his feet. View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

30-Year-Old With Foot Inversion Injury

A 30-year-old man presents to urgent care with lateral ankle pain and swelling after a foot inversion injury he sustained while hiking. A mortise view x-ray of the ankle is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

16-Year-Old With History Of Orchiopexy

A 16-year-old male with a history of orchiopexy presents with syncope. He denies chest pain or shortness of breath. An ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

38-Year-Old With Foot Rash

A 38-year-old man presents to urgent care for a pruritic rash that developed on his feet over the last week. The rash is worse on his left foot than the right. He frequently works out and showers at the gym before going to work. On examination, fine, powdery, scaly plaques are seen on his soles and insteps. He otherwise appears well and has no systemic symptoms. View the image below and consider what your diagnosis …