Shoulder Pain in the Urgent Care
Urgent message: Shoulder pain is not always “just another musculoskeletal complaint.” It may be referred pain indicating life-threatening conditions. Many patients use urgent care centers as sources of primary care. Thus when we make an important diagnosis because of our methodical, stepwise approach to examination, we have the opportunity to be the providers who ultimately expedite diagnosis and care for these patients. MIZUHO SPANGLER, DO, and MICHAEL B. WEINSTOCK, MD Shoulder pain is the third …
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Upper Gastrointestinal Disorders in Urgent Care, Part 2: Biliary Tract and Pancreatic Disease
Urgent message: Upper abdominal pain is a common presentation in urgent care practice. Narrowing the differential diagnosis is sometimes difficult. Understanding the pathophysiology of each disease is the key to making the correct diagnosis and providing the proper treatment. TRACEY Q. DAVIDOFF, MD Part 1 of this series focused on disorders of the stomach—gastritis and peptic ulcer disease—on the left side of the upper abdomen. This article focuses on the right side and center of …
Read MoreMay 2015
Upper Gastrointestinal Disorders in Urgent Care, Part 1: Gastritis, Peptic Ulcer Disease, and Helicobacter pylori
Urgent message: Gastritis and peptic ulcer disease are a spectrum of diseases that can range from mild to serious; urgent care providers must be on the alert for these conditions. Early diagnosis and treatment, along with recommendations for follow-up care with appropriate specialists, can help prevent long-term sequelae. TRACEY Q. DAVIDOFF, MD Gastritis and peptic ulcer disease (PUD) represent a continuum along a path of inflammation of the gastric mucosa, from superficial irritation of the …
Read MoreApril 2015
Urgent Care Evaluation of Fatigue
Ever heard the old (and not so funny) joke about two health-care providers having a conversation at the urgent care center? First provider: “Ever seen a case of _____?” Second provider: “Turns out I have seen plenty of cases . . . just never diagnosed any!” With a nonspecific presenting condition such as fatigue, it is difficult to obtain an adequate medical history and to perform a thorough physical examination unless the differential diagnosis is …
Read MoreMarch 2015
Medication Issues in Urgent Care
Urgent message: Polypharmacy—taking multiple medications to treat several chronic medical problems—puts patients at increased risk of developing additional health issues when they are prescribed even more medications for acute conditions in an urgent care center. JASMEET SINGH BHOGAL, MD It is not uncommon for patients, especially elderly patients, presenting to an urgent care center to have multiple medical problems. This makes it more likely that they are taking multiple medications as well. In fact, according …
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