RESUMO
Joint and soft-tissue aspiration and injection procedures are relatively easy to master once the physician has acquired an understanding of the techniques and subtleties of performing these procedures at certain sites. These techniques can be used to diagnose and treat many painful joint and soft-tissue conditions and are useful additions to the primary care physician's treatment repertoire.
Assuntos
Anti-Inflamatórios/administração & dosagem , Injeções Intra-Articulares/métodos , Artropatias/tratamento farmacológico , Drenagem/instrumentação , Drenagem/métodos , Articulação do Cotovelo/anatomia & histologia , Medicina de Família e Comunidade/métodos , Humanos , Injeções Intra-Articulares/instrumentação , Articulação do Joelho/anatomia & histologia , Atenção Primária à Saúde/métodos , Articulação do Ombro/anatomia & histologia , Esteroides , Articulações Tarsianas/anatomia & histologia , Articulação do Punho/anatomia & histologiaRESUMO
Successful joint and soft-tissue aspiration and injection rely on the physician's understanding of the indications, contraindications, and general techniques involved in these procedures. The procedures are generally well tolerated and can be used to treat many painful musculoskeletal and soft-tissue conditions.
Assuntos
Injeções Intra-Articulares/métodos , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/tratamento farmacológico , Sucção/métodos , Anestésicos Locais/administração & dosagem , Equipamentos e Provisões , Glucocorticoides/administração & dosagem , Humanos , Injeções Intra-Articulares/efeitos adversos , Injeções Intra-Articulares/instrumentação , Guias de Prática Clínica como Assunto , Sucção/efeitos adversos , Sucção/instrumentaçãoRESUMO
Spondylolysis is the most common identifiable cause of back pain in active adolescents, who often cope with the condition by hoping it will just go away. If the pain is prolonged or severe enough to bring them to a physician, an aggressive work-up for a specific diagnosis should be initiated. History and physical exam findings are suggestive but not diagnostic. Radiographs provide a first look, but other tests (eg, bone scans, CT, and MRI) are necessary to determine the metabolic activity and full extent of any lesions. Conservative therapy, including activity modification, physical therapy, and sometimes bracing, provides pain relief and focuses on return to full activity and prevention of recurrence.
RESUMO
Each year ankle sprains account for a significant degree of disability and expense. Thus, it is important that family physicians become familiar with methods of preventing ankle sprains. Both internal and external methods prevent ankle injuries. Internal methods include improving flexibility, strength and proprioception; effective external methods of ankle protection include using athletic tape, lace-up stabilizers and semirigid orthoses.
Assuntos
Traumatismos do Tornozelo/prevenção & controle , Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/anatomia & histologia , Humanos , Aparelhos OrtopédicosRESUMO
Occipital neuralgia, a painful condition thought to be caused by nerve entrapment, has been described in the general population. Athletes, particularly those who participate in collision sports, such as football, may be predisposed to this condition. An illustrative case is presented along with discussion of the differential diagnosis and treatment of this type of headache.
Assuntos
Futebol Americano/lesões , Síndromes de Compressão Nervosa/etiologia , Neuralgia/etiologia , Osso Occipital/inervação , Adulto , Anestésicos Locais/administração & dosagem , Bupivacaína/administração & dosagem , Plexo Cervical , Diagnóstico Diferencial , Cefaleia/diagnóstico , Humanos , Hiperestesia/etiologia , Lidocaína/administração & dosagem , Masculino , Síndromes de Compressão Nervosa/tratamento farmacológico , Neuralgia/tratamento farmacológico , Osso Parietal/inervação , Couro Cabeludo/inervaçãoRESUMO
BACKGROUND: This study was undertaken to demonstrate the relative frequency of disqualifying criteria in a complete history and physical sports examination. METHODS: A review was conducted of 2574 preparticipation physical evaluations (PPEs) performed on 11- to 18-year-old student athletes to determine which factors are associated with denial of unrestricted sports participation. RESULTS: Eighty-five percent of the student athletes passed the screening. Of those who did not, the denial decision was based on the medical history alone in 58% of cases (P < .05). A logistic regression analysis identified seven items associated with denial: dizziness with exercise, history of asthma, body mass index, systolic blood pressure, visual acuity, heart murmur, and musculoskeletal examination. CONCLUSIONS: Although physicians often take a complete history and perform physical examinations, relatively few variables appear related to denial of eligibility for participation in organized sports. The history is one of the most important aspects of the PPE. A directed PPE may be more efficient, thereby allowing more time to address other important issues.
Assuntos
Traumatismos em Atletas/prevenção & controle , Nível de Saúde , Anamnese , Exame Físico , Esportes , Adolescente , Criança , Feminino , Controle de Formulários e Registros , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Estados UnidosRESUMO
Clinically apparent thyroid nodules occur in about 5 percent of the population. Because most patients with thyroid nodules present initially to their primary care physician, family physicians should have a thorough understanding of the diagnosis and treatment of thyroid nodules. The history and physical examination may be helpful in detecting thyroid nodules but are not useful in predicting malignancy. Furthermore, laboratory studies, ultrasonography and nuclear medicine scans do not reliably differentiate between benign and malignant thyroid nodules. In most cases, fine-needle aspiration biopsy can accurately identify malignant thyroid nodules. Fine-needle aspiration biopsy is safe and can be performed in an office setting.
Assuntos
Nódulo da Glândula Tireoide/diagnóstico , Biópsia por Agulha , Diagnóstico Diferencial , Humanos , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/economiaRESUMO
Calcitonin has been observed to have an analgesic effect on painful bone conditions. A case illustrating the antinociceptive effect of calcitonin on bone pain caused by osteoporotic vertebral compression fracture is presented. There is increasing clinical evidence supporting this phenomenon, though few rigorously controlled studies exist. Calcitonin may have an advantage over other analgesics in the treatment of bone pain resulting from an osteoporotic compression fracture, because, in addition to the observed analgesic effect, it is useful in treating the underlying disorder.