Practice Management
The patient is a 35-year-old male who presents to urgent care with acute pain in his left shoulder after falling during a bicycle ride. Pain is worse with movements, but he is able to range the shoulder somewhat. You observe bruising and swelling at the impact site. View the images taken and consider what your diagnosis and next steps would be.
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A 62-year-old man presents with right shoulder pain that began the previous evening after he fell in his garage. The pain is worse with movement through the range of motion. He has no pain in the elbow and says that he has no head pain or head injury. His social history reveals that he is a smoker and drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis would be.
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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 …
Read MoreShoulder Pain in a Young Male Urgent message: Traumatic injury isn’t the only factor to be weighed in patients with subluxation. Author: Ralph S. Bovard, MD Author Information: Ralph S. Bovard, MD, is a staff physician in the Department of Orthopedics and Sports Medicine, University of Minnesota Physicians, Minneapolis, MN. Case Presentation An 18-year-old male presented to the clinic with a complaint of left shoulder pain. He had been riding on a metro bus a …
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There are some diagnoses that will be missed by nine out of 10 physicians; this is one of them. However, our goal is not to meet “Standard of Care” but to provide excellence in care: Take every patient at face value, without trying to guess their intentions for secondary gain. Ensure you are aware of the chief complaint stated to the staff in the urgent care center. Be an open book in your impression and …
Read MoreIn 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 e-mail the relevant materials and presenting information to [email protected]. The patient is a 62-year-old who presents with a primary complaint of right shoulder pain that developed over time. The patient denies any trauma. The patient is …
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