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Musculoskeletal diagnosis

Neige M Journy, Kieran McHugh, Richard W Harbron, Mark S Pearce, Amy Berrington de Gonzalez
OBJECTIVE: To describe medical conditions associated with the use of CT in children or young adults with no previous cancer diagnosis. METHODS: Radiologists' reports for scans performed in 1995-2008 in patients <22 years of age were collected from the Radiology Information System in 44 hospitals of Great Britain. By semantic search, an automated procedure identified 192 medical conditions within the radiologists' reports. Manual validation of a subsample by a paediatric radiologist showed a satisfactory performance of the automatic coding procedure...
October 21, 2016: British Journal of Radiology
Michael S Crowell, Erik A Dedekam, Michael R Johnson, Scott C Dembowski, Richard B Westrick, Donald L Goss
BACKGROUND: While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic...
October 2016: International Journal of Sports Physical Therapy
Orjan Skogar, Johan Lokk
This review focuses on the diagnosis and management of Parkinson-related pain which is one of the more frequently reported nonmotor symptoms in Parkinson's disease (PD), which is the second most common neurodegenerative disease after Alzheimer's disease. Pain is ranked high by patients as a troublesome symptom in all stages of the disease. In early-stage PD, pain is rated as the most bothersome symptom. Knowledge of the correct diagnosis of pain origin and possible methods of treatments for pain relief in PD is of great importance...
2016: Journal of Multidisciplinary Healthcare
Susan Peters, Venerina Johnston, Sonia Hines, Mark Ross, Michel Coppieters
BACKGROUND: Carpal tunnel syndrome (CTS) is a common problem, that can be effectively managed by surgery. Screening for prognostic factors is important to identify workers who are at a greater risk of a poor work outcome in order to implement tailored interventions to facilitate their return-to-work. OBJECTIVE: To synthesize the best available evidence on the association of preoperative prognostic factors with work-related outcomes in people who have undergone carpal tunnel surgery...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
Kris Radcliff, William B Morrison, Christopher Kepler, Jeffrey Moore, Gursukhman S Sidhu, David Gendelberg, Luciano Miller, Marcos A Sonagli, Alexander R Vaccaro
STUDY DESIGN: Retrospective case series. OBJECTIVE: To identify specific magnetic resonance imaging (MRI) characteristics of epidural fluid collections associated with infection, hematoma, or cerebrospinal fluid (CSF). SUMMARY OF BACKGROUND DATA: Interpretation of postoperative MRI can be challenging after lumbar fusion. The purpose of this study was to identify specific MRI characteristics of epidural fluid collections associated with infection, hematoma, or CSF...
November 2016: Clinical Spine Surgery
Harry Hx Wang, Jia Ji Wang, Kenny D Lawson, Samuel Ys Wong, Martin Cs Wong, Fang Jian Li, Pei Xi Wang, Zhi Heng Zhou, Yao Qun Yeong, Sian M Griffiths, Stewart W Mercer
OBJECTIVE: Multimorbidity (having ≥2 chronic conditions within an individual) is a rapidly increasing problem particularly among hypertensive patients. This study compared the prevalence of hypertension and those with multimorbidity in three study populations. DESIGN AND METHOD: We used cross-sectional data from three self-report surveys in China [N = 162,464], Scotland [N = 36,921], and Hong Kong [N = 29,187]. A consistent methodology was adopted to select representative samples of the household resident population of all ages by multi-stage stratified random sampling in each area...
September 2016: Journal of Hypertension
Kathryn E Mansfield, Julius Sim, Peter Croft, Kelvin P Jordan
Chronic widespread pain (CWP) is common in the general population. It is unclear how people reporting this problem present in primary care; they may regularly consult for regional pains without being recognized as having a generalized condition. Our objectives were to determine the prevalence of people consulting in primary care for musculoskeletal conditions in different body regions on different occasions (recurrent regional pain consultation), the proportion with diagnosed generalized pain and survey-reported widespread pain, and if they have features characteristic of CWP...
September 29, 2016: Pain
Eugene Y Kissin, Michael H Pillinger
No abstract text is available yet for this article.
October 16, 2016: Arthritis & Rheumatology
Kevin R Math, Jennifer L Berkowitz, Stephen A Paget, Yoshimi Endo
Diagnostic imaging plays a crucial role in confirming the diagnosis of musculoskeletal (MSK) infection and determining the severity and extent of disease. The clinical diagnosis may be challenging due to the nonspecific presentation of pain and swelling. There are certain features that are pathognomonic for infection. Pre-existing conditions an make diagnosing infection difficult. Prior surgery can create artifacts on advanced imaging modalities such as computed tomography and MRI, obscuring the tissues immediately around the hardware...
November 2016: Rheumatic Diseases Clinics of North America
Michiro Susa, Kazutaka Kikuta, Robert Nakayama, Kazumasa Nishimoto, Keisuke Horiuchi, Sota Oguro, Masanori Inoue, Hideki Yashiro, Seishi Nakatsuka, Masaya Nakamura, Morio Matsumoto, Kazuhiro Chiba, Hideo Morioka
BACKGROUND: Historically, local control of recurrent sarcomas has been limited to radiotherapy when surgical re-resection is not feasible. For metastatic carcinomas to the bone or soft tissue, radiotherapy and some interventional radiology treatment along with other systemic therapies have been widely advocated due to the possibility of disseminated disease. These techniques are effective in alleviating pain and achieving local control for some tumor types, but it has not been effective for prolonged local control of most tumors...
October 13, 2016: BMC Cancer
Mohammad Reza Hayeri, Pouya Ziai, Monda L Shehata, Oleg M Teytelboym, Brady K Huang
Infection of the musculoskeletal system can be associated with high mortality and morbidity if not promptly and accurately diagnosed. These infections are generally diagnosed and managed clinically; however, clinical and laboratory findings sometimes lack sensitivity and specificity, and a definite diagnosis may not be possible. In uncertain situations, imaging is frequently performed to confirm the diagnosis, evaluate the extent of the disease, and aid in treatment planning. In particular, cross-sectional imaging, including computed tomography and magnetic resonance imaging, provides detailed anatomic information in the evaluation of soft tissues due to their inherent high spatial and contrast resolution...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Mark J Kransdorf, Mark D Murphey
Radiologic evaluation of musculoskeletal soft-tissue masses has changed dramatically with the continued improvements in imaging technology. The integration of advanced imaging has provided the radiologist with a wide range of assessment tools, but as with all powerful arsenals, selection and application of the appropriate imaging method can be problematic. Although the choices available for imaging evaluation of musculoskeletal masses have changed dramatically, the basic objectives of this assessment have remained constant: diagnosis and staging...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Benjamin Wang, Florian J Fintelmann, Ravi S Kamath, Susan V Kattapuram, Daniel I Rosenthal
OBJECTIVE: The objective of this study is to determine how a limited protocol MR examination compares to a full conventional MR examination for the detection of non-degenerative pathology such as acute fracture, infection, and malignancy. MATERIALS AND METHODS: A sample of 349 non-contrast MR exams was selected retrospectively containing a 3:1:1:1 distribution of negative/degenerative change only, acute fracture, infection, and malignancy. This resulted in an even distribution of pathology and non-pathology...
October 10, 2016: Skeletal Radiology
V S C Fung
Gait disorder is a common accompaniment of functional neurologic disorders. The diagnosis of a functional or psychogenic gait is complex. It requires a sound knowledge of the range of phenomenology observed in organic movement disorders, the ability to evaluate and diagnose nonmovement disorder neurologic symptoms and signs, but additionally knowledge of potential musculoskeletal causes of gait disturbance. A stepwise approach to the analysis of the phenomenology and separation into four (sometimes overlapping) psychogenic gait syndromes is suggested to aid diagnosis: (1) movement disorder mimics; (2) neurologic (nonmovement disorder) mimics; (3) musculoskeletal or biomechanical mimics; and (4) isolated disequilibrium or balance disorders...
2017: Handbook of Clinical Neurology
Linda S Chesterton, Krysia S Dziedzic, Danielle A van der Windt, Graham Davenport, Helen L Myers, Trishna Rathod, Milica Blagojevic-Bucknall, Sue M Jowet, Claire Burton, Edward Roddy, Elaine M Hay
BACKGROUND: Patients diagnosed with idiopathic mild to moderate carpal tunnel syndrome (CTS) are usually managed in primary care and commonly treated with night splints and/or corticosteroid injection. The comparative effectiveness of these interventions has not been reliably established nor investigated in the medium and long term. The primary objective of this trial is to investigate whether corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over 6 weeks when compared with night splints...
October 6, 2016: BMC Musculoskeletal Disorders
John Z Srbely, Dinesh Kumbhare, Liza Grosman-Rimon
Myofascial pain syndrome (MPS) is one of the most common conditions of chronic musculoskeletal pain encountered by primary healthcare practitioners on a daily basis. It is generally accepted amongst the broad profile of healthcare practitioners treating MPS that the presence of discrete, palpable and tender nodules within the muscle, known as myofascial trigger points (MTrP), is necessary to confirm the diagnosis of MPS. Manual palpation is currently the most common technique used to detect MTrP, however, previous research has shown that the reliability of manual palpation for detecting MTrP is poor, and in our opinion unacceptably poor, leading to inconsistent diagnosis of MPS and poor patient outcomes...
September 2016: Journal of the Canadian Chiropractic Association
Mathilde M Bruins Slot-Steenks, Neveen A T Hamdy, Michiel A J van de Sande, Dennis Vriens, Arjen H G Cleven, Natasha M Appelman-Dijkstra
Tumor-induced osteomalacia is a rare acquired metabolic bone disorder characterized by isolated renal phosphate wasting due to abnormal tumor production of fibroblast growth factor 23. We report the case of a 59 year old woman referred to our department with a long history of progressive diffuse muscle weakness and pain, generalized bone pains and multiple insufficiency fractures of heels, ankles and hips due to a hypophosphatemic osteomalacia. A fibroblast growth factor 23-producing phosphaturic mesenchymal tumor localized in the left quadriceps femoris muscle was identified 7 years after onset of symptoms...
October 5, 2016: Endocrine
Jose M Remes-Troche
Chest pain that is not explained by reflux disease or cardiac, musculoskeletal, mucosal, or motor esophageal abnormalities is classified as functional chest pain (FCP). Although several mechanisms are involved, esophageal hypersensitivity plays a major role and it could be considered a biomarker for FCP. Psychologic comorbidity such as anxiety, neuroticism, depression, and somatization is common. When the diagnosis of FCP is suspected, patients should undergo evaluation with esophageal motility testing, endoscopy, 24-h esophageal pH monitoring, and in some cases, sensory tests...
October 5, 2016: Current Treatment Options in Gastroenterology
Jasmin B Kuemmerle-Deschner, Seza Ozen, Pascal N Tyrrell, Isabelle Kone-Paut, Raphaela Goldbach-Mansky, Helen Lachmann, Norbert Blank, Hal M Hoffman, Elisabeth Weissbarth-Riedel, Boris Hugle, Tilmann Kallinich, Marco Gattorno, Ahmet Gul, Nienke Ter Haar, Marlen Oswald, Fatma Dedeoglu, Luca Cantarini, Susanne M Benseler
Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate diagnostic criteria for CAPS. An innovative process was followed including interdisciplinary team building, item generation: review of CAPS registries, systematic literature review, expert surveys, consensus conferences for item refinement, item reduction and weighting using 1000Minds decision software...
October 4, 2016: Annals of the Rheumatic Diseases
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