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Musculoskeletal surgery is invaluable for unintentional injury. But for conditions associated with chronic pain (e.g., knee, shoulder, wrist, neck, back pain), even patients with objective changes on imaging that need intervention will not have better long-term pain relief with surgery compared with no surgery.
Fractures of the radius and ulna are the most common fractures of the upper extremity. Patients with radius and ulna fractures often present with reduced range of movement in the joint adjacent to the fracture. Radiography or ultrasonography can confirm the diagnosis, but repeat imaging may be needed if initially negative. Although nondisplaced or minimally displaced fractures can be managed with immobilization, it is important to identify fractures that require referral to an orthopedist.
Telemedicine has become a valuable tool during the coronavirus disease 2019 pandemic. Musculoskeletal issues are a common reason for primary care visits and can often be managed using telemedicine, especially if a standardized approach is used. This article discusses telemedicine methods and techniques, including visit preparation, virtual history collection and physical examination, and initial treatment options.
The American Academy of Family Physicians and the American College of Physicians have published guidelines based on a systematic review and network meta-analysis of 207 studies involving 32,959 patients that evaluated treatments for acute musculoskeletal pain other than low back pain.
Primary care plays a large role in the management of acute pain; therefore, the American College of Physicians and the American Academy of Family Physicians developed a clinical practice guideline for the nonpharmacologic and pharmacologic management of acute pain from non–low back, musculoskeletal ...
Physicians should consider the ramifications before ordering an MRI in the setting of chronic pain. An MRI that is not indicated can lead to a procedure that is not necessary as both patient and physician focus on the abnormal study finding. Most patients improve with conservative management that requires active involvement.
Because no individual therapy for chronic musculoskeletal pain has consistent benefit, a multimodal treatment approach is recommended. Many nonpharmacologic, noninvasive treatment approaches yield small to moderate improvement in pain and function. This article summarizes the evidence for these therapies, which can be used with pharmacologic or more invasive modalities.
The American Physical Therapy Association released guidelines for the diagnosis and management of patellofemoral pain.
This meta-analysis found no evidence that the monoclonal antibody denosumab reduces the risk of fracture more than bisphosphonates.
A teenaged baseball player presented with left knee pain, bruising, and swelling, as well as subjective quadriceps weakness 10 days after sustaining a leg injury while sliding into home plate.