Articles - February 15, 1998 - American Family Physician


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667 Management of Shoulder Impingement Syndrome and Rotator Cuff Tears
ALLEN E. FONGEMIE, M.D., DANIEL D. BUSS, M.D., and SHARON J. ROLNICK, PH.D.
Rotator cuff impingement and tears are shoulder problems frequently encountered by family physicians. Learning to conduct a thorough, concise examination of the shoulder will help family physicians diagnose and treat these problems.

Patient information: "Four Exercises to Strengthen the Muscles of Your Rotator Cuff," p. 680

685 Testicular Masses
JENNIFER JUNNILA, CPT, MC, USA, and PATRICK LASSEN, MAJ, USAF, MC
A knowledge of normal male genital anatomy and the pathophysiology of major emergency and benign processes causing testicular masses allows family physicians to appropriately manage patients and refer them to a urologist when indicated.

699 Electrocardiographic Manifestations and Differential Diagnosis of Acute Pericarditis
MARK A. MARINELLA, M.D.
Acute pericarditis has a variety of etiologies and produces characteristic findings on ECG, including diffuse ST-segment elevation that, at times, may be difficult to distinguish from changes of acute myocardial infarction or other conditions.

711 Diagnostic Evaluation of Dyspnea
WALTER C. MORGAN, M.D., and HEIDI L. HODGE, M.D.
Dyspnea, like other undifferentiated general symptoms, can best be diagnosed with the help of a careful history and physical examination. Selective diagnostic testing can be helpful in difficult cases.

719 Problem-Oriented Diagnosis
Occupational Lead Poisoning
KEVIN C. STAUDINGER, M.D., M.P.H., and VICTOR S. ROTH, M.D., M.P.H.
Despite our increased awareness of the adverse health effects of lead, occupational lead poisoning continues to be a major problem, requiring a high index of suspicion for accurate diagnosis. Prompt removal of the worker from the source of exposure remains the mainstay of treatment.

Patient information: "Lead and Your Health," p. 731

735 Conjunctivitis
GARY L. MORROW, M.D., and RICHARD L. ABBOTT, M.D.
While the etiology of conjunctivitis can usually be determined on the basis of the history and ocular examination, cultures are sometimes necessary to establish the diagnosis and guide therapy.

749 Isoniazid Overdose: Recognition and Management
JENNIFER A. ROMERO, D.O., and FRANK J. KUCZLER, JR., M.D.
Isoniazid toxicity can result in recurrent seizures, profound metabolic acidosis, coma and death.

755 An Algorithm for the Evaluation of Peripheral Neuropathy
ANN NOELLE PONCELET, M.D.
Electromyography and nerve conduction studies can help distinguish axonal from demyelinating neuropathies.

765 Diagnosis and Treatment of Cutaneous Vascular Lesions
FERN A. WIRTH, M.D., and MARK H. LOWITT, M.D.
Hemangiomas typically have proliferative, stationary and involutional phases. Many resolve without treatment, but others, often because of their location, require prompt intervention.

776 Subclinical Hypothyroidism: Deciding When to Treat
VICTOR ADLIN, M.D.
An isolated thyrotropin-stimulating hormone elevation usually indicates an early stage of thyroid failure. Because subtle symptoms and changes in lipid levels and cardiac function are common in this condition, treatment with levothyroxine may be advisable.

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	Articles
667	Management of Shoulder Impingement Syndrome and Rotator Cuff Tears ALLEN E. FONGEMIE, M.D., DANIEL D. BUSS, M.D., and SHARON J. ROLNICK, PH.D. Rotator cuff impingement and tears are shoulder problems frequently encountered by family physicians. Learning to conduct a thorough, concise examination of the shoulder will help family physicians diagnose and treat these problems.
	Patient information: "Four Exercises to Strengthen the Muscles of Your Rotator Cuff," p. 680
685	Testicular Masses JENNIFER JUNNILA, CPT, MC, USA, and PATRICK LASSEN, MAJ, USAF, MC A knowledge of normal male genital anatomy and the pathophysiology of major emergency and benign processes causing testicular masses allows family physicians to appropriately manage patients and refer them to a urologist when indicated.
699	Electrocardiographic Manifestations and Differential Diagnosis of Acute Pericarditis MARK A. MARINELLA, M.D. Acute pericarditis has a variety of etiologies and produces characteristic findings on ECG, including diffuse ST-segment elevation that, at times, may be difficult to distinguish from changes of acute myocardial infarction or other conditions.
711	Diagnostic Evaluation of Dyspnea WALTER C. MORGAN, M.D., and HEIDI L. HODGE, M.D. Dyspnea, like other undifferentiated general symptoms, can best be diagnosed with the help of a careful history and physical examination. Selective diagnostic testing can be helpful in difficult cases.
719	Problem-Oriented Diagnosis Occupational Lead Poisoning KEVIN C. STAUDINGER, M.D., M.P.H., and VICTOR S. ROTH, M.D., M.P.H. Despite our increased awareness of the adverse health effects of lead, occupational lead poisoning continues to be a major problem, requiring a high index of suspicion for accurate diagnosis. Prompt removal of the worker from the source of exposure remains the mainstay of treatment.
	Patient information: "Lead and Your Health," p. 731
735	Conjunctivitis GARY L. MORROW, M.D., and RICHARD L. ABBOTT, M.D. While the etiology of conjunctivitis can usually be determined on the basis of the history and ocular examination, cultures are sometimes necessary to establish the diagnosis and guide therapy.
749	Isoniazid Overdose: Recognition and Management JENNIFER A. ROMERO, D.O., and FRANK J. KUCZLER, JR., M.D. Isoniazid toxicity can result in recurrent seizures, profound metabolic acidosis, coma and death.
755	An Algorithm for the Evaluation of Peripheral Neuropathy ANN NOELLE PONCELET, M.D. Electromyography and nerve conduction studies can help distinguish axonal from demyelinating neuropathies.
765	Diagnosis and Treatment of Cutaneous Vascular Lesions FERN A. WIRTH, M.D., and MARK H. LOWITT, M.D. Hemangiomas typically have proliferative, stationary and involutional phases. Many resolve without treatment, but others, often because of their location, require prompt intervention.
776	Subclinical Hypothyroidism: Deciding When to Treat VICTOR ADLIN, M.D. An isolated thyrotropin-stimulating hormone elevation usually indicates an early stage of thyroid failure. Because subtle symptoms and changes in lipid levels and cardiac function are common in this condition, treatment with levothyroxine may be advisable.