Showing 41-60 of 97 for: Essential Evidence Topics > Musculoskeletal 
- Hip pain
Essential Evidence Topics, 7-Sep-2021
Overall Bottom Line: Order imaging in adults with acute trauma, those with suspicion of malignancy (eg, age, history of cancer, weight loss), and patients with persistent symptoms after conservative treatment. MRI is the preferred study if clinical susp
- Juvenile idiopathic arthritis
Essential Evidence Topics, 10-Nov-2021
Overall Bottom Line: Children suspected of having juvenile idiopathic arthritis (JIA) should be referred to a subspecialist (pediatric rheumatologist or orthopedist) as early as possible. Children with JIA are at risk for asymptomatic uveitis and should
- Knee injection (procedure)
Essential Evidence Topics, 6-Sep-2022
Indications for Procedure: Anesthetic/Corticosteroid Combination Injecting an anesthetic/corticosteroid solution may provide prompt, focal pain relief from noninflammatory, inflammatory, and crystal arthritides. Candidates for injection include patients w
- Knee injury (ligamentous and meniscal)
Essential Evidence Topics, 3-Feb-2023
Overall Bottom Line: McMurray maneuver and joint line testing can be helpful in detecting meniscal injuries. Patients with meniscal injuries should be given a trial of nonsurgical treatment, because no randomized trials have compared surgical versus non
- Knee pain (diagnostic evaluation)
Essential Evidence Topics, 23-Jan-2023
Overall Bottom Line: Aspirate a swollen knee that is warm or erythematous and send the fluid for cell count, crystals, and culture. Initial imaging for patients not responding to conservative therapy should include at a minimum AP and lateral radiograph
- Leg cramps
Essential Evidence Topics, 2-Feb-2022
Overall Bottom Line: The patient's medications should be reviewed carefully because they are a common cause of leg cramps. Quinine is effective in treating leg cramps, but severe adverse reactions have been reported and most preparations have been banne
- Legg-Calve-Perthes disease
Essential Evidence Topics, 5-Jul-2021
Overall Bottom Line: Consider Legg-Calve-Perthes disease (LCPD) in a child that presents with a limp, hip pain, referred pain to the knee, limited range of motion in hip abduction and internal rotation, or antalgic gait. Obtain plain anteroposterior (AP)
- Malignant hyperthermia
Essential Evidence Topics, 6-Feb-2022
Overall Bottom Line: Malignant hyperthermia is a rare inherited disorder leading to a syndrome of hypermetabolism after exposure to volatile anesthetics agents or depolarizing muscle relaxants such as succinylcholine. Typical symptoms include muscular r
- Medial and lateral epicondylitis
Essential Evidence Topics, 16-Sep-2021
Overall Bottom Line: Acute epicondylitis can be managed with icing, relative rest, stretching, and eccentric strengthening exercises. NSAIDs are effective for acute tendonitis, but have no effect on long-term outcomes. Steroid injections are low risk,
- Medial and lateral epicondylitis injection (procedure)
Essential Evidence Topics, 19-Sep-2022
Indications for procedure: Epicondylitis is inflammation of the bony origin of the wrist extensors (lateral or tennis elbow) or wrist flexors (medial or golfer's elbow), usually from repetitive use. Indications for procedure include: Persistent symptoms
- Metatarsalgia
Essential Evidence Topics, 23-Apr-2022
Overall Bottom Line: Careful clinical evaluation is the most accurate way to make the appropriate diagnosis. MRI and ultrasound are sensitive and highly specific in evaluating patients with metatarsalgia of various etiologies, especially when symptoms p
- Mixed connective tissue disorder
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: Suspect mixed connective tissue disorder (MCTD) in any patient, particularly a young woman, who presents with Raynaud's phenomenon and features of other connective tissue diseases. High-titer antiribonucleoprotein (also known as U1-
- Monoarticular arthritis (diagnostic approach)
Essential Evidence Topics, 23-Mar-2022
Overall Bottom Line: Patient history and physical exam guide the rational use of sequential laboratory and imaging studies for diagnosing monoarticular arthritis. Patients with a history of trauma or focal bone pain require radiographs of the affected joi
- Morton's neuroma
Essential Evidence Topics, 9-Aug-2021
Overall Bottom Line: Patients with Morton's neuroma typically present with interdigital plantar foot pain that becomes worse with walking. They also have pain with pressure to the intermetatarsal space and may have a Mulder's click on exam. Diagnosis is
- Muscular dystrophy
Essential Evidence Topics, 10-Apr-2023
Overall Bottom Line: Patients typically present with mild hypotonia at birth and delayed milestones; by the age of 5 years, greater proximal weakness than distal weakness is apparent. If Duchenne muscular dystrophy (DMD) is suspected, order creatine kinas
- Myasthenia gravis
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: No universally accepted and validated diagnostic criteria exist for myasthenia gravis (MG). The diagnosis is made when patients have fatigability and weakness of muscles and have abnormal diagnostic tests. Anticholinesterase drugs s
- Neck pain
Essential Evidence Topics, 21-Dec-2022
Overall Bottom Line: Suspect metastatic malignancy in patients with neck pain and an elevated erythrocyte sedimentation rate (ESR) or lytic lesions on neck radiographs. Order cervical spine radiographs for patients with chronic neck pain, suspicion for
- Necrotizing fasciitis
Essential Evidence Topics, 31-Jul-2021
Overall Bottom Line: Suspect necrotizing fasciitis (NF) when a patient presents with cellulitis and pain out of proportion to the severity of the lesion, signs of systemic toxicity (hypotension, tachycardia, and hyperthermia), bullae, patches of cutaneous
- Osteoarthritis
Essential Evidence Topics, 17-Mar-2023
Overall Bottom Line: For evaluation of suspected osteoarthritis (OA), order weight-bearing anterior views. Acetaminophen and NSAIDS should be the first-line drug treatment for OA; opiates should be avoided. . The 2020 ACR guidelines made strong recommen
- Osteochondritis dissecans
Essential Evidence Topics, 19-Jul-2022
Overall Bottom Line: Consider osteochondritis dissecans (OCD) in the young to middle-aged patient with acute knee or ankle trauma that is not improving as expected or in the patient with repetitive overuse injury and chronic, nonspecific joint complaints.
