Showing 61-80 of 97 for: Essential Evidence Topics > Musculoskeletal 
- Osteogenesis imperfecta
Essential Evidence Topics, 23-Jun-2021
Overall Bottom Line: Osteogenesis imperfecta (OI) is a heterogeneous group of genetic connective-tissue disorders resulting in bone fragility for which there is no curative treatment. Diagnosis is typically based on a family history of bone fragility, d
- Osteomyelitis
Essential Evidence Topics, 16-Sep-2021
Overall Bottom Line: MRI is more accurate than technetium-99m bone scanning, plain radiography, and white cell studies in the diagnosis of osteomyelitis of the foot and ankle. PET scanning may be helpful for chronic osteomyelitis. A parenteral antibio
- Osteoporosis
Essential Evidence Topics, 21-Dec-2022
Overall Bottom Line: The United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis in women 65 years or older and and in postmenopausal women younger than age 65 years who are at increased risk of osteoporosis as determin
- Paget's disease of bone (osteitis deformans)
Essential Evidence Topics, 4-Jan-2023
Overall Bottom Line: Order plain radiographs at one or more sites to document the diagnosis, as well as a radionuclide bone scan to document the extent of disease. In patients with radiographic evidence of disease, serum alkaline phosphatase is sufficie
- Pain management (chronic non-malignant)
Essential Evidence Topics, 17-Mar-2023
Overall Bottom Line: There is no test to measure pain. Imaging correlates poorly with symptoms. The patient’s report of pain is your guide. Consider the safest therapies first: acetaminophen, cognitive behavioral therapy, and exercise. Effective optio
- Patellofemoral syndrome
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: The diagnosis of patellofemoral pain syndrome is clinical and centered around a combination of key historical and physical exam findings. The mainstay of treatment includes education as well as a dedicated physical therapy program.
- Pigmented villonodular synovitis
Essential Evidence Topics, 11-Apr-2023
Overall Bottom Line: Because of the low incidence of this locally aggressive but benign proliferative disease of the synovium, a high index of suspicion is necessary to make the diagnosis of pigmented villonodular synovitis (PVNS). MRI is the imaging st
- Plantar fasciitis
Essential Evidence Topics, 1-Oct-2021
Overall Bottom Line: Diagnosis of plantar fasciitis is based on characteristic history and physical examination findings. Standard therapies, including orthotics and night splints, are minimally more effective than stretching exercises or no treatment a
- Poliomyelitis
Essential Evidence Topics, 23-Nov-2021
Overall Bottom Line: The Centers for Disease Control and Prevention (CDC) recommends that all children receive inactivated polio vaccine (IPV) at the ages of 2, 4, 6 to 18 months, and 4 to 6 years. Suspect post-polio syndrome in patients with prior para
- Polyarteritis nodosa
Essential Evidence Topics, 5-Jul-2021
Overall Bottom Line: Polyarteritis nodosa (PAN) is a systemic vascular necrotizing vasculitis that typically affects medium-sized arteries, with occasional involvement of small muscular arteries. Most of the cases are idiopathic. Hepatitis B virus (HBV)
- Polyarticular arthritis (diagnostic approach)
Essential Evidence Topics, 12-Jul-2021
Overall Bottom Line: History and physical examination findings outweigh laboratory testing in the definitive diagnosis of polyarticular arthritis. Consider synovial fluid analysis if you are unable to differentiate inflammatory from noninflammatory arth
- Polymyalgia rheumatica
Essential Evidence Topics, 4-Mar-2021
Overall Bottom Line: Consider Polymyalgia rheumatica (PMR) in patients older than age 50 years with abrupt onset of severe muscle stiffness and pain in the shoulders, neck, buttocks, and thighs. An elevated sedimentation rate is an important part of the
- Psoriatic arthritis
Essential Evidence Topics, 25-Jan-2021
Overall Bottom Line: Suspect psoriatic arthritis in patients with inflammatory joint disease and a history of psoriasis. The Classification Criteria for Psoriatic Arthritis (CASPAR) criteria () use simple clinical, laboratory, and radiographic clues to i
- Raynaud's phenomenon
Essential Evidence Topics, 19-Apr-2021
Overall Bottom Line: Raynaud's phenomenon is characterized by pale or cyanotic digits triggered by cold or stress, sometimes associated with pain or numbness, and followed by reactive hyperemia upon rewarming. Determine whether Raynaud's phenomenon is s
- Regional pain syndrome
Essential Evidence Topics, 19-Jul-2022
Overall Bottom Line: Complex regional pain syndrome (CRPS) is a rare disorder that typically develops four to six weeks after direct trauma, such as an injury or surgery; pain is usually out of proportion to the inciting injury. The diagnosis is clinica
- Reiter's syndrome
Essential Evidence Topics, 29-Mar-2023
Overall Bottom Line: Reiters syndrome (reactive arthritis, ReA) is a clinical syndrome classified as a seronegative spondylarthropathy. Patients typically present with asymmetric oligoarthritis of lower extremities, enthesitis, conjunctivitis or anterio
- Rhabdomyolysis
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Early recognition of rhabdomyolysis is essential to prevent acute renal failure (ARF). The classic triad of rhabdomyolysis consists of myalgias, generalized weakness, and darkened urine; however, only 50% of patients present with th
- Rhabdomyosarcoma
Essential Evidence Topics, 30-Dec-2021
Overall Bottom Line: Rhabdomysocarcoma is detected clinically and is confirmed via biopsy. Initial imaging is radiographic, followed by CT without contrast or MRI. Prognosis is based on histologic characteristics and extent of disease. Initial treat
- Rheumatoid arthritis (adult)
Essential Evidence Topics, 8-Aug-2022
Overall Bottom Line: Use the American College of Rheumatology (ACR) diagnostic criteria () to determine whether rheumatoid arthritis is present and the Netherlands RA Clinical Prediction Score to estimate the probability of developing rheumatoid arthritis
- Scleroderma (progressive systemic sclerosis)
Essential Evidence Topics, 10-Aug-2022
Overall Bottom Line: The diagnosis of systemic scleroderma requires the presence of the lone major criterion (proximal scleroderma) or 2 minor criteria (sclerodactyly, digital pitting scars or a loss of substance from finger pads, or bibasilar pulmonary f
