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Musculoskeletal Disorders

The diagnosis and pharmacologic management of low back pain

Betty Larsen, PA-C, Susan Kuntz, PhD March 01, 2012

Low back pain takes a physical, financial, and emotional toll on the patient and imposes  socioeconomic costs as well. A clear understanding of causes and treatments is essential.

Increasing hip pain in an elderly woman

Scott Walton, PA-C February 22, 2012

Incapacitating pain and decreased range of motion sideline a previously healthy, active, and independent elderly patient.

An adolescent hockey player suffers a rare injury in an uncommon location

Bruce S. Rudy, DEd, PA-C  August 01, 2011

Various radiographic views found no injury, but limited range of motion and pain persisted.

Acute peroneal tendon tear: Extreme pain indicative of more than a sprain

Patrick Gray, MPAS, PA-C April 11, 2011

The patient's injury was diagnosed as an ankle sprain, but worsening pain and MRI findings indicated a more serious diagnosis.

Progressive paresthesias and pain in the extremities, chest, and abdomen following a seizure

Jason G. Homer, PA-C February 16, 2011

Two weeks after a grand mal seizure, a male patient presents to neurology with numbness, posterior neck pain, and trouble with balance.

Tendinopathy resulting from the use of fluoroquinolones: Managing risks

Heidi E. Doyle, PA-C December 01, 2010

Although well-tolerated by most patients, fluoroquinolones can produce this serious  condition.

Hip resurfacing: A fresh look at an alternative to total joint arthroplasty

Andrew H. Patterson, PA-C, Jackie H. Coleman, CST September 02, 2010

Improved devices make the procedure a viable option for a select group of patients with hip arthritis.

Imaging and biopsy hold the key to knee pain diagnosis

Julie Vajnar, PA-C, RT July 27, 2010

The patient's complaints suggested injury to the meniscus, but radiography, MRI, and biopsy revealed a different cause.

A rare combination of uveitis, salivary gland swelling, and cranial nerve palsy in a febrile woman

Jason Evanchan, DO; Timothy J. Barreiro, DO, FCCP, FACOI; David Gemmel, PhD May 17, 2010

Bilateral swollen parotid glands trigger an evaluation and imaging studies that uncover ocular, neurologic, and pulmonary abnormalities.

Remitting seronegative symmetrical synovitis with pitting edema

Linda Sekhon, MMS, PA-C February 22, 2010

RS3PE must be distinguished from other forms of arthritis and PMR to avoid exposing the patient to inappropriate therapy.

Bowing of the right lower leg in an infant

Jason R. Smith, PA-C, Richard Davidson, MD February 16, 2010

The baby's tibia exhibited a lytic lesion and medial cortical disruption, and the fibula showed mild cortical thickening.

Surgical treatments for patients with an infected total knee arthroplasty

Joseph Kotelnicki, PA-C; Kevin Mitts, MD November 23, 2009

Two-stage revision arthroplasty is the usual treatment for an infected knee replacement, but less invasive procedures may also work.

An alternative perspective on how to treat Achilles' tendon injuries

November 20, 2009

How to diagnose and manage an acute Achilles tendon rupture

Foot pain for 5 years, and an abnormal radiograph

Captain Amelia Duran-Stanton PA-C, PhD, MPAS November 17, 2009

Learn to recognize the clinical manifestations and radiographic appearance of a condition you may never have heard of.

Persisting shin tenderness and erythema

David M. Alden-St. Pierre, MS, PA-C October 20, 2009

This patient experienced shin pain after a long walk. The next day, an ankle sprain was diagnosed. The clue was in his medical history of thyroid cancer.

How to diagnose and manage an acute Achilles tendon rupture

David V. Cary, MPA, PA-C August 04, 2009

Patients with this complex and disabling injury need to be prepared for a long healing process, regardless of treatment modality.

QRS: Alzheimer's disease; Myasthenia gravis

Dawn Colomb-Lippa, MHS, PA-C, Amy M. Klingler, MS, PA-C, Margaret King-Schumacher, PA-C,MJ July 21, 2009

Features, signs and symptoms, and treatment of Alzheimer's disease and myasthenia gravis are reviewed. Questions and answers that highlight important facts about these diseases are also included.

How to perform a comprehensive examination of the knee

LT Kerri Browne, MSBS, PA-C, CDR Christopher A. Kurtz, MD June 01, 2009

This step-by-step guide describes a thorough knee examination that will lead to an accurate diagnosis of knee pathology.

Imaging focused on a tooth reveals an unusual mass

Denise Rizzolo, PA-C, PhD, Andrea Medel; Thomas Chiodo, DDS May 19, 2009

Facial pain and swelling attributed to an impacted wisdom tooth turn out to be signs of a life-threatening diagnosis.

An unusual diagnosis for persistent leg pain in an adolescent girl

Pamela Y. Young, RPA-C January 01, 2009

This condition should be in the differential diagnosis for any patient presenting with extremity pain.

Longstanding anterior pelvic pain

Chris A. Webb, MS, PA-C; Matthew L. Jimenez,MD December 01, 2008

The patient is a 74-year-old white woman who presented with complaints of longstanding anterior pelvic pain over the symphysis pubis. She reported a baseline dull and aching pain but experienced sharp, stabbing sensations at the pubic symphysis when performing benign activities such as rising from a seated position or getting in and out of her car.

Scoliosis: A straightforward approach to diagnosis and management

Jason R. Smith, PA-C; Daniel M. Sciubba, MD; Amer F. Samdani, MD November 11, 2008

Scoliosis should be no more intimidating to manage than acute otitis media. This article reviews how to treat patients with the condition before and after referral to a specialist.

A common cause of knee pain in athletic children

Denise Rizzolo, PA-C, PhD, Hilary Sugar; Stanley C. Parman, MD November 01, 2008

A 13-year-old female presented with a 4-day history of left knee pain. The pain had come on suddenly. The patient stated that after she walked home from school, she had some moderate knee discomfort; then, after dinner, she noticed increased pain and swelling just below her patella.

CME Posttest: Multiple myeloma; Scoliosis

November 01, 2008

November 2008

Evaluation and treatment of patients with low back pain

Cpt. Alan Nelson, MPAS, PA-C April 01, 2007

Most back pain resolves promptly and spontaneously, and conservative treatment is effective in most cases that do not. Only in rare instances is this condition a sign of severe disease.

The nonoperative management of shoulder instability

Vinh Dang, MPAS, PA-C March 01, 2007

Here are techniques for making an accurate diagnosis, managing patients conservatively without surgery, and safely returning them to their premorbid level of activity.

Atraumatic snapping brachialis in a 37-year-old woman

Bruce S. Rudy, MS, PA-C; April D. Armstrong, MD January 01, 2007

Brachialis muscle (brachialis anticus) injury is an uncommon cause of pain or incapacitation in the adult population. Accurate diagnosis can be difficult even with today's technological advances. Surgical exploration may be necessary to make a definitive diagnosis.

Plain films show the most common hip problem of adolescence

Julie Vajnar, PA-C, RT November 01, 2006

The patient is a 13-year-old boy with pain in the left thigh and no history of trauma. His symptoms started about 2 months ago and have gradually worsened.

Health-related implications and management of sarcopenia

Ronald J. Zacker, MPAS, PA-C, RD, CDE, CPT October 01, 2006

This age-related deterioration in functionality is, to some extent, preventable. Furthermore, encouraging patients to adopt healthy eating and exercise habits can even reverse some of the effects.

A rare and painful deformity of the wrist

Amanda M. Murphy, MPAS, PA-C May 01, 2006

A 13-year-old premenarchal female presented with a 1-year history of left wrist pain and progressive flexion deformity. She described the pain as a dull ache, predominantly on the ulnar side, that increased throughout the day. The pain was moderately severe and, apart from NSAIDs, which provided only minimal relief, nothing made the pain better or worse. The patient was left-handed, and the pain was limiting her ability to write in school.