Availability of basic x-ray capabilities differentiates urgent care centers from walk-in primary-care and retail clinics, which lack such capabilities. According to an analysis of nearly 50,000 patient encounters by Practice Velocity and Teleradiology Specialists, approximately 11% of urgent care visits require an x-ray. The top 10 views, summarized here by Current Procedural Technology (CPT) codes, account for 86% of urgent care x-rays. (Note: The top 10 views include 11 views because of the equal percentage of …
Read MoreClinical Challenge: April, 2013
In each issue, JUCM will challenge your diagnostic acumen with a glimpse of x-rays, electrocardiograms, and photographs of dermatologic conditions that real urgent care patients have presented with. If you would like to submit a case for consideration, please email the relevant materials and presenting information to [email protected]. The patient, a 37-year-old woman, presented after a blow to her left hand. View the image taken (Figure 1) and consider what your diagnosis would be.
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55-year-old woman with injury to her right finger
The patient, a 55-year-old woman, injured her right ring finger after missing a grab at her dog’s collar while the dog was running away. She complained of being unable to bend the end of the finger and pain in her palm. There was no numbness. Notice the excessive extension of the distal phalanx at rest. Now consider the x-ray series. After viewing the images taken, consider what your diagnosis would be.
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27-year-old presents a jammed right finger
This otherwise healthy 27-year-old jammed his right finger today. NL distal perfusion. Palpable reduction achieved with traction. Continued instability. Subluxates with flexion. Therefore, placed in splint to return for ortho tonight. View the image taken and consider what your diagnosis and next steps would be. Click on the button below to see the resolution of the case.
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35-year-old female catches finger in banister
The patient is a 35-year-old female who got her finger caught in a metal staircase banister one day prior to presentation. Physical examination is significant for right fifth PIP hyperextension and DIP hyperflexion (swan neck deformity). The patient\’s PIP flexion appears to be limited to about 20 degrees, while her contralateral PIP joint shows about 100 degrees of flexion. No sensory or motor deficits are noted. View the x-ray taken and consider what your diagnosis …
Read MoreClinical Challenge: January, 2009
The patient is a 35-year-old female who got her finger caught in a metal staircase banister one day prior to presentation. Physical examination is significant for R 5th finger PIP hyperextension and DIP hyperflexion (swan neck deformity). Her PIP flexion limited to about 20°, while her contralateral PIP joint shows about 100 degrees of flexion. No sensory or motor deficits noted. View the x-rays taken (Figure 1 and 2) and consider what your diagnosis and …
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