Does This Patient Have a Torn Meniscus or Ligament of the Knee? Value of the Physical Examination
Article Abstract:
A group of physical findings combined with medical history is more accurate in detecting a torn meniscus of ligament in the knee, according to researchers who analyzed 23 studies that compared specific physical findings and a combination of physical findings against arthroscopy or magnetic resonance imaging. Specific tests included the anterior drawer test, the Lachman test, and the McMurray test.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2001
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Does this patient have ascites? How to divine fluid in the abdomen
Article Abstract:
The presence of a fluid wave, shifting dullness, or peripheral edema are the best diagnostic tests for ascites. The absence of increased abdominal girth, bulging flanks, flank dullness or shifting dullness effectively rules out ascites. Ascites is fluid in the abdominal cavity, and it can be a sign of heart failure, liver disease, kidney disease, or cancer. It is caused by a disruption in the balance between fluid in the blood vessels and that in the tissues. The gold standard for diagnosing ascites is paracentesis and ultrasound imaging. The best bedside diagnostic tests for ascites are bulging flanks, flank dullness, shifting dullness and a fluid wave. Studies have found that bulging flanks, flank dullness and shifting dullness are highly sensitive for ascites. The absence of a fluid wave has a very high specificity.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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Costs, outcomes, and patient satisfaction by provider type for patients with rheumatic and musculoskeletal conditions: a critical review of the literature and proposed methodological standards
Article Abstract:
The question of who provides better care for patients with low back pain, arthritis, or gout depends on the disease. Researchers analyzed 17 studies that compared treatments and outcomes by type of practitioner. Treatment varied by type of practitioner for low back pain. All appeared equally effective. Patients preferred chiropractors. For arthritis and gout, rheumatologists tended to use diagnostic procedures and treatments more appropriately and to achieve better results. However, the studies have important deficiencies in their design that weaken any conclusions.
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1997
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