Journal of Urgent Care Medicine

When a Fever is Not a URI: If It’s Not in the Differential, It Won’t Be in the Diagnosis

Urgent message: Fever in patients presenting to UC is often attributable to viral infections, urinary tract infections, otitis media, cellulitis, or pneumonia. When the source is not apparent after the initial evaluation, however, it is important to expand the differential in order to avoid missing less common, serious diagnoses. Samidha Dutta, DO; Caleb Marsh, OMS-IV, UP-KYCOM; Michael Weinstock, MD CASE PRESENTATION A 74-year-old man with a history of Parkinson’s disease and diabetes presented with 2 …

A Legal Quandary: A Diagnosis of Cellulitis…That Isn’t

Michael Weinstock, MD; Gabby Gostigian, MD; and Matthew Delaney, MD Urgent message: Failure to consider subtleties and the context in which a patient presents can lead to insufficient differential diagnoses and missed diagnoses that leave the patient at risk for poor outcomes and the provider at risk for litigation. INTRODUCTION Cellulitis from a wound infection in the urgent care is common, and so is our management: wound care and antibiotics. But consider a scenario in …

Where Should I Refer My Spinal Patient? Outcomes with Orthopedic and Neurosurgeons for Common Neck and Back Procedures

Urgent message: Neck and back pain are common issues preceding surgical intervention. Given differences in care plans, outcomes, cost, and length of stay associated with spinal surgeries, the option of referring urgent care patients to either neurosurgeons or orthopedic spine surgeons requires careful consideration. Rami Musleh, PA-C; Angela Blagojevski, MPAS, PA-C; Randy Brush, MS, PA-C; and Jessica Bruskoski, MS, PA-C INTRODUCTION Neck and back pain are two of the most common reasons for people to …

Psychiatric Manifestations of Organic Disease: Don’t Get Fooled!

Urgent message: Mistaking medical symptoms for psychiatric disease can delay care and lead to adverse outcomes. Elizabeth Yeager-Cordial, MD; Janell Ison, DO; Robert Becker, MD; Courtney Boyd, MD; and Michael Weinstock, MD Citation: Yeager-Cordial E, Ison J, Becker R, Boyd C, Weinstock M. Psychiatric manifestations of organic disease: don’t get fooled! J Urgent Care Med. 2022;16(11):11-15. CASE PRESENTATION A 23-year-old man presented with a strange complaint: visual hallucinations. He had no psychiatric history and was …

Management of Burn Blisters in Urgent Care

Urgent message: Though data are limited and approaches to burn blister management remain controversial (eg, leaving blisters intact vs deroofing or aspirating), appropriate initial care in the urgent care setting is both feasible and advisable and can reduce risk for infection and scarring. Muhammad Zeeshan Ahmed MBBS, FRNZCUC, Winston McEwan FRACS, and Sana Maqsood MPhil, Cert PH Citation: Ahmed MZ, McEwan W, Maqsood S. Management of burn blisters in urgent care. J Urgent Care Med. …

Essential Tools for Urgent Care—Finger Tourniquet

Urgent message: Use of a finger tourniquet can ensure a bloodless field when performing laceration repair to fingers and toes, thereby reducing risk for damage to underlying vital structures and increasing the prospects for positive outcomes. Patrick O’Malley, MD After repairing scores of finger lacerations over the years, I have learned there are a few essential supplies required for these cases; the most critical among them, however, is the finger tourniquet. This simple device makes …

Physical Therapy as Nonsurgical Management and Presurgical Management of Most Common Knee Pathologies

Urgent message: Appreciation for the cause of knee pain, along with an understanding of potential nonoperative rehabilitation therapies that could be provided in urgent care, can enhance patient care and improve patient satisfaction while minimizing the need for referral. Dr. Eva Delgado Martinez MBChB, GP, MScCN and Dr. Ivan Koay MBChB, FRNZCUC, MD INTRODUCTION Knee injuries in adults and children are common presentations to urgent care and emergency rooms.1 Rehabilitation of those injuries is essential …

Knee Immobilization for Acute Knee Injuries: A Review

Urgent message: Immobilization following acute knee injury occurs more commonly than the evidence might dictate in urgent care and other acute care settings. Evaluation of data in existing literature suggest that this common practice carries risk for adverse effects when not warranted. Matthew Bruce Baird, MD, CAQ-SM; Mallory Shasteen, MD, CAQ-SM; and Vicki Nelson, MD, CAQ-SM. Citation: Baird MB, Shasteen M, Nelson V. Knee immobilization for acute knee injuries: a review. J Urgent Care Med. …

When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging

Urgent message: Musculoskeletal pain is a common urgent care complaint, with x-rays very commonly ordered. However, a “normal” image does not necessarily support eliminating what could be a serious injury from the differential diagnosis. Arun Sayal, MD, CCFP(EM) Citation: Sayal A. When X-Rays Lie: Important Orthopedic Diagnoses to Consider with Normal Imaging. J Urgent Care Med. 2022;16(7):13-16. Medical tests lie. Not intentionally, of course, but their result may not align with reality. A test may …

Evaluating Decreased Libido: The Lowdown on Low T

Urgent message: Hypogonadism not only impedes biological development, but also negatively impacts a patient’s sense of identity and well-being. Prompt diagnosis is achievable through strategic utilization of hormone level testing in conjunction with a patient’s stated symptoms and medical history. Lisa O. Iyeke, BS and Mark J. Richman, MD, MPH Citation: Iyeke LO, Richman MJ. Evaluating decreased libido: the lowdown on low T. J Urgent Care Med. 2021;16(6):33-34. CASE PRESENTATION A 46-year-old male with benign …