Musculoskeletal Care

Feb 15, 2000 Issue
Evaluation of the Acutely Limping Child [Article]

A limp may be defined as any asymmetric deviation from a normal gait pattern. The differential diagnosis of a limp includes trauma, infection, neoplasia and inflammatory, congenital, neuromuscular or developmental disorders. Initially, a broad differential diagnosis should be considered to avoid ove...

Feb 1, 2000 Issue
Evaluation of Overuse Elbow Injuries [Article]

The evaluation of elbow pain can be challenging because of the complexity of the joint and its central location in the upper extremity. Diagnosing the injury correctly requires an understanding of the anatomy of the elbow, which includes three articulations, two ligament complexes, four muscle group...

Jan 1, 2000 Issue
Osteochondritis Dissecans: A Diagnosis Not to Miss [Article]

Osteochondritis dissecans is the most common cause of a loose body in the joint space in adolescent patients. Because clinical findings are often subtle, diagnosis requires a high index of suspicion. Limited range of motion may be the only notable clinical sign. The diagnosis is made by radiographic...

Dec 01, 1999 Issue
Acute Knee Injuries: Use of Decision Rules for Selective Radiograph Ordering [Article]

Family physicians often encounter patients with acute knee trauma. Radiographs of injured knees are commonly ordered, even though fractures are found in only 6 percent of such patients and emergency department physicians can usually discriminate clinically between fracture and nonfracture. Decision ...

Nov 1, 1999 Issue
Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment [Article]

Managing patellofemoral pain syndrome is a challenge, in part because of lack of consensus regarding its cause and treatment. Contributing factors include overuse and overload of the patellofemoral joint, biomechanical problems and muscular dysfunction. The initial treatment plan should include quad...

May 15, 1999 Issue
Shoulder Instability in Young Athletes [Article]

May 1, 1999 Issue
Fractures of the Proximal Fifth Metatarsal [Article]

Fractures of the proximal portion of the fifth metatarsal may be classified as avulsions of the tuberosity or fractures of the shaft within 1.5 cm of the tuberosity. Tuberosity avulsion fractures cause pain and tenderness at the base of the fifth metatarsal and follow forced inversion during plantar...

Apr 15, 1999 Issue
Plantar Fasciitis and Other Causes of Heel Pain [Article]

The most common cause of heel pain is plantar fasciitis. It is usually caused by a biomechanical imbalance resulting in tension along the plantar fascia. The diagnosis is typically based on the history and the finding of localized tenderness. Treatment consists of medial arch support, anti-inflammat...

Apr 1, 1999 Issue
Adhesive Capsulitis: A Sticky Issue [Article]

The shoulder is a very complex joint that is crucial to many activities of daily living. Decreased shoulder mobility is a serious clinical finding. A global decrease in shoulder range of motion is called adhesive capsulitis, referring to the actual adherence of the shoulder capsule to the humeral he...

Jul 01, 1998 Issue
Lisfranc Injury of the Foot: A Commonly Missed Diagnosis [Article]

Lisfranc joint injuries are rare, complex and often misdiagnosed. Typical signs and symptoms include pain, swelling and the inability to bear weight. Clinically, these injuries vary from mild sprains to fracture-dislocations. On physical examination, swelling is found primarily over the midfoot regi...

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