Journal of Urgent Care Medicine

Urgent Care Assessment of Patients with Possible Diverticulitis

Urgent Message: Diverticulitis is a prevalent condition characterized by localized inflammation most commonly of the sigmoid colon. It is often diagnosed with a computed tomography scan with intravenous contrast. Uncomplicated cases are most common and require only monitoring, however complicated cases can require hospitalization and emergent surgical intervention. Urgent care clinicians should be comfortable assessing patients with possible diverticulitis and recognizing features that suggest the possibility of more complicated disease. Naushair Hussain DO; Shahmeer Hussain …

Rural Urgent Care Growth Continues, But Challenges Remain

Urgent Message: Rural urgent care is the industry’s fastest growing segment, influenced by rural primary care shortages, hospital closures and extended ED wait times, but operational staffing and reimbursement complexities must be navigated. Alan A. Ayers, MBA, MAcc Citation: Ayers A. Rural Urgent Care Grows, But Challenges Remain. J Urgent Care Med. 2024; 19(3): 17-21 As access to care in rural areas continues to decline, urgent care (UC) can play a pivotal role in the …

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From Disc Herniation: A Case Report

Urgent Message: Abdominal pseudohernia is a rare diagnosis with variable presentation. Urgent care clinicians who are familiar with the condition and its variable presentations can reduce the risk of diagnostic errors and unnecessary or inappropriate diagnostic testing. Berkeley E Prewett, BSA; Stephen V Green, MD; Andrew L Juergens II, MD; Taylor K Ratcliff, MD Citation: Prewett BE, Green SV, Juergens AL, Ratcliff TK. Abdominal Pseudohernia and Urinary Retention Due to Spinal Nerve Root Compression From …

Urgent Care Recognition and Management of Proximal Humerus Fractures

Urgent Message: Proximal humerus fractures most commonly occur in older patients after a fall and can be sentinel events that offer an opportunity to identify undiagnosed medical conditions or unsafe home environments. Lauren Schuermann, MS4; Shivani Kothari, MS4; W. Bradley Strauch, MD Citation: Schuermann L, Kothari S, Strauch B. Urgent Care Recognition and Management of Proximal Humerus Fractures. J Urgent Care Med. 2024; 19(2): 13-19 Questions for the Clinician at the Bedside Clinical Scenario A …

Recognition and Management of Achenbach Syndrome (Paroxysmal Finger Hematoma)

Urgent Message: By understanding the symptoms of paroxysmal finger hematoma, clinicians can reduce patient anxiety and decrease unnecessary testing, as the condition is generally mild and has a favorable prognosis. Citation: Sanz Martinez E, Kranichfeld WH, Ceballos Y. Achenbach Syndrome: Diagnosis of Paroxysmal Finger Hematoma. J Urgent Care Med. 2024; 19(1): 25-29 Introduction Paroxysmal finger hematoma (PFH), also known as Achenbach syndrome, is a vascular disorder of unknown etiology characterized by subcutaneous bleeding in the …

Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures

Urgent Message: It’s important to recognize the difference between a proximal 5th metatarsal fracture of the tuberosity alone and a proximal metaphyseal fracture, commonly referred to as a “Jones fracture.” A Jones fracture requires full immobilization with urgent surgical referral. Michael B. Weinstock, MD; Kelly Moore, BS Citation: Weinstock M, Moore K. Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures. J Urgent Care Med. 2024 18(7):25-28 Editors’ Note: While the images presented here …

Isolated Sternal Fractures After Trampoline Falls in Children: A Case Series

Urgent Message: Isolated sternal fractures in children can occur from relatively minor trauma, such as a trampoline fall, and patients can often be managed conservatively. NaShayla Davis, MD; Olabisi Pearse, MD; Swati Mahajan, MD; Marie-Helene Gagnon, MD; Rebecca Burger, MD Citation: Davis N, Pearse O, Mahajan S, Gagnon MH, Burger R. Isolated Sternal Fractures After Trampoline Falls in Children: A Case Series. J Urgent Care Med. 2024; 18(6): 13-16 Key Words: Trampoline, Fall, Fracture, Injury, …

An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism Diagnosis

Francesca Cocchiarale, DO; Alexa Bailey, MS-3; Michael Weinstock, MD Urgent Message: Pulmonary embolism can be frequently missed as a diagnosis because it can present with a variety of signs and symptoms. Understanding clinical decision rules and myriad presentations can help urgent care providers determine when patients benefit from immediate referral to an emergency department. Citation: Cocchiarale F, Bailey A, Weinstock M. An Atypical Cause of Fever and Confusion: A Case Report of Delayed Pulmonary Embolism …

Charting with Purpose: Precision Strategies for Accurate Coding and Malpractice Defense

Jeff Willis, MD Urgent Message: A well-told story explaining your thought process during a patient encounter will contain all the elements required for accurate coding. Attorneys are less likely to question care when a logical and complete story is clearly documented. Citation: Willis J. Charting with Purpose: Precision Strategies for Accurate Coding and Malpractice Defense. J Urgent Care Med. 2024; 18(4) 13-16. As a medical legal consultant, I have learned medical malpractice claims are an …

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