Practice Management
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.
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Figure 1. The patient is a 32-year-old woman who presents with ankle pain following a fall in which she twisted her ankle. She reports that she was texting while walking her dog and stumbled off the curb. View the image taken and consider your next steps, along with possible diagnoses.
Read MoreThe patient is a 21-year-old male who presents with persistent ankle pain 4 weeks after suffering a trauma. He fell while scaling the exterior of his dormitory, trying to gain entry into a second-floor window because he’d locked his keys inside. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A new patient—a 45-year-old man who says he’s been plagued by midfoot pain for several weeks—presents to your urgent care center. The foot is normal in appearance, but it is evident that the patient has pain palpation over the midfoot. There is no pain with palpation over the plantar aspect. Skin does not show signs of infection. The neurovascular status is intact. View the image taken and consider your next steps, along with possible diagnoses.
Read MoreThe patient is an otherwise healthy child, 3.5 years of age, who presents with acute pain in his right lower arm to the elbow. Examination reveals multiple fractures. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreUrgent message: Fractures of the distal radius are a common presentation in the urgent care setting. Nonetheless, a high index of suspicion is required for the diagnosis of a Galeazzi fracture–dislocation.By Heather L Hinshelwood, MD and David Caro, MD IntroductionThe anatomic structure of the forearm typically maintains the integrity of the distal radioulnar joint when the radius is fractured. However, in certain situations this joint may be compromised with certain rotational forces. CaseA 14-year-old African-American male …
Read MoreDAVID STERN, MD (Practice Velocity) The urgent care practitioner may not live by coding alone, but proper reimbursement depends on it. To that end, Dr. David Stern, who is in great demand as a speaker and consultant on coding in urgent care, will offer answers to commonly asked questions in every issue of JUCM. In this issue, he addresses a potpourri of issues raised by urgent care practitioners. Q.A consultant tells us that we have …
Read MoreA 53-year-old female presents after experiencing a fall with a blow to the knee several hours earlier. Upon examination, you find: No fluid in the knee The knee is stable Patient is able to put weight on the affected knee Mildly decreased range of motion due to generalized pain in the area (though not over the patella) View Figure 1, take these findings into account, and consider what your next steps would be. Resolution of …
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