Showing 1-20 of 97 for: Essential Evidence Topics > Musculoskeletal 
- Abnormal gait in children
Essential Evidence Topics, 26-Nov-2021
Overall Bottom Line:
- Achilles tendinitis
Essential Evidence Topics, 9-Jul-2021
Overall Bottom Line: Acute Achilles pain (symptoms less than 6 weeks in duration) is best treated with ice, stretching, and activity and footwear modification. Chronic Achilles tendinosis (more than 6 weeks in duration) should be treated with an eccentr
- Achilles tendon rupture
Essential Evidence Topics, 16-Feb-2021
Overall Bottom Line: A positive Thompson (calf squeeze) test is highly suggestive of achilles tendon rupture in the patient who presents with the acute onset of posterior heel pain and an appropriate mechanism of injury. Operative versus nonoperative ma
- Ankle injury
Essential Evidence Topics, 5-Mar-2021
Overall Bottom Line: Use Ottawa ankle rules to determine whether x-ray is necessary to rule out fracture. Use Protection, Rest, Ice, Compression, Elevation (PRICE) mnemonic to guide conservative initial therapy. Nonsteroidal anti-inflammatory drugs (N
- Ankylosing spondylitis
Essential Evidence Topics, 27-May-2021
Overall Bottom Line: Symptoms suggesting inflammatory back pain include: onset before age 40, insidious onset, persistence of pain for at least 3 months, morning stiffness, and improvement with exercise. Radiographic sacroiliitis confirms the diagnosis;
- Ankylosing spondylitis
Essential Evidence Topics, 27-May-2021
Overall Bottom Line: Symptoms suggesting inflammatory back pain include: onset before age 40, insidious onset, persistence of pain for at least 3 months, morning stiffness, and improvement with exercise. Radiographic sacroiliitis confirms the diagnosis;
- Arthritis (septic or pyogenic)
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: Fever, inability to bear weight, sed rate >40 s, and WBC >12,000 are the best independent predictors of septic arthritis in children. The cornerstone of diagnosis of septic arthritis is arthrocentesis and synovial fluid analys
- Avascular necrosis
Essential Evidence Topics, 28-Feb-2022
Overall Bottom Line: Although a variety of mechanisms have been proposed for the development of avascular necrosis of the femoral head, no single etiology has been identified; however, the basic mechanism involves impaired circulation to a specific area t
- Back pain (low, acute)
Essential Evidence Topics, 9-Dec-2022
Overall Bottom Line: In the absence of "red flag" symptoms, clinicians should not routinely order imaging or other diagnostic tests in patients with nonspecific low back pain (LBP). Imaging after a trial of therapy is recommended for patients with signs
- Back pain (low, chronic)
Essential Evidence Topics, 21-Dec-2022
Overall Bottom Line: The United States Preventive Services Task Force (USPSTF) found insufficient evidence for or against the routine use of interventions such as increased physical activity to prevent lower back pain (LBP) in adults. Diagnostic imaging
- Biceps tendinitis injection (procedure)
Essential Evidence Topics, 16-Feb-2021
Indications for the Procedure: Patients with biceps tendonitis typically present with pain in the anterior shoulder. The pain is usually localized to the bicipital (intertubercular) groove, but can radiate down the arm to the hand or to the deltoid muscle
- Brachial plexus injury
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Obstetric training in management of shoulder dystocia may prevent bracheal plexus injury at birth. Evaluate for brachial plexus injury in all cases of shoulder dystocia. Congenital plexopathy may spontaneously resolve within month
- Bruxism (tooth grinding)
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: Abnormal tooth wear, orofacial pain, temporomandibular joint (TMJ) sounds, and difficulty closing the mouth support the diagnosis. Occlusal mouth splints are the mainstay of treatment for sleep bruxism to protect teeth from damage,
- Bunions
Essential Evidence Topics, 3-Aug-2021
Overall Bottom Line: Suspect hallux valgus (bunion) in a patient who presents with history of progressive forefoot pain and a bump or lateral deviation of the great toe seen on examination. Confirm this with weight-bearing radiographs. For mildly symp
- Calcium Pyrophosphate Deposition Disease (CPPD) or Pseudogout
Essential Evidence Topics, 2-Nov-2022
Overall Bottom Line: Calcium pyrophosphate deposition (CPPD) disease previously known as pseudogout is arthritis caused by the deposition of calcium pyrophosphate dihydrate (CPPD) crystal in articular tissue. Patients typically present with fairly rapid
- Carpal tunnel syndrome
Essential Evidence Topics, 22-Sep-2021
Overall Bottom Line: Carpal tunnel syndrome (CTS) remains a clinical diagnosis, with electromyelogram as the best confirmatory test. Symptoms that correlate best with an abnormal electromyelogram include hypalgesia, abnormal hand diagram results, and we
- Child with a limp
Essential Evidence Topics, 13-Feb-2022
Overall Bottom Line: Limp is a common source of parental and physician concern. The majority of cases of limp are due to mild trauma and resolve without treatment. Differentiation between antalgic and non-antalgic gait is important. Rarely does non-an
- Coccygeal injury
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: The most frequent cause of coccygeal injury in adults is trauma. Physical examination may reveal ecchymosis in the acute stage, localized sacrococcygeal joint pain and tenderness, and pain with sacrococcygeal motion on rectal examin
- Compartment syndromes
Essential Evidence Topics, 28-Jan-2022
Overall Bottom Line: Acute compartment syndrome (ACS) can occur in any part of the body, usually at the site of a traumatic injury. ACS is an emergency that should be treated with immediate surgical intervention. Chronic exertional compartment syndrome
- Costochondritis and Tietze syndrome
Essential Evidence Topics, 14-Apr-2021
Overall Bottom Line: Diagnosis is clinical, and imaging studies are not routinely recommended. Rule out other causes of anterior chest wall pain, especially if the patient is at increased risk for cardiopulmonary disease. NSAIDs are the most widely us
