Journal of Urgent Care Medicine

Abstracts in Urgent Care – December 2024

ECG Interpretation: Humans Vs Machines Take Home Point: In this study, cardiologists and emergency physicians (EP) had greater accuracy for electrocardiogram (ECG) interpretation than current versions of ChatGPT and Gemini. Citation: Günay S, Öztürk A, Yiğit Y. The accuracy of Gemini, GPT-4, and GPT-4o in ECG analysis: A comparison with cardiologists and emergency medicine specialists. Am J Emerg Med. 2024 Oct:84:68-73. doi: 10.1016/j.ajem.2024.07.043. Relevance: Artificial Intelligence (AI) is rapidly evolving and becoming an integral part …

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 …

55-Year-Old With Wrist Pain

A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray 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.

30-Year-Old With Back Pain

A 30-year-old woman presents to urgent care with pain in her lower back and pelvis. She denies any injury or accident that might be causing her pain. She has just returned to full-time work after having a baby. An x-ray 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.

29-Year-Old With Chronic Hip Pain

A 29-year-old man presents to urgent care complaining of chronic right hip pain with movement and exercise. He’s an avid mountain climber and used to play sports in college. Review the images and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

12-Year-Old With Facial Trauma

A 12- year-old male presents to urgent care with his mother complaining of facial pain. The patient experienced a trip-and-fall accident at home. He landed on a carpeted floor and now complains of facial pain. View the image taken (occipitomental/Waters view) and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

Benefits of Utilizing Limited-Scope X-Ray Techs in the Urgent Care Setting

Urgent message: X-ray is an essential component of urgent care operations. Amid rising costs and staffing shortages, limited-scope x-ray techs may be a viable alternative to licensed radiology techs to perform imaging in the clinic. Alan A. Ayers, MBA, MAcc One of the unexpected changes we’ve seen come out of the COVID-19 pandemic is the difficulty urgent care centers face in hiring licensed radiologic technologists (RTs). Even hospitals struggle to hire, offering sign-on bonuses of …

Clavicular Pain in a 23-Year-Old

Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …

Shoulder Pain in a 62-Year-Old After a Fall

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.

Clinical Challenge 2: June, 2015

The CaseA child presents after a fall on an outstretched arm from monkey bars. Pain and voluntary guarding of the elbow are noted. View the image taken (Figure 1) and consider what your diagnosis would be.

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