Review

Authors: Miguel Ángel Saavedra, José Eduardo Navarro-Zarza, Pablo Villaseñor-Ovies...

The clinical anatomy of several pain syndromes of the knee is herein discussed. These include the iliotibial tract syndrome, the anserine syndrome, bursitis of the medial collateral ligament, Baker's cyst, popliteus tendon tenosynovitis and bursitis of the deep infrapatellar bursa. These syndromes are reviewed in terms of the structures involved and their role in knee physiology. All of the discussed structures can be identified in their normal state and more so when they are affected by disease. The wealth of information gained by cross examination of the medial, lateral, posterior and anterior aspects of the knee brings to life knowledge acquired at the dissection table, from anatomical drawings and from virtual images.

Topics: Diagnosis, Differential; Humans; Knee Injuries; Knee Joint; Musculoskeletal Diseases; Musculoskeletal Pain; Physical Examination; Syndrome

PubMed: 23219082
DOI: 10.1016/j.reuma.2012.10.002

Review

Authors: Joyce A Adams, Karen J Farst, Nancy D Kellogg...

Most sexually abused children will not have signs of genital or anal injury, especially when examined nonacutely. A recent study reported that only 2.2% (26 of 1160) of sexually abused girls examined nonacutely had diagnostic physical findings, whereas among those examined acutely, the prevalence of injuries was 21.4% (73 of 340). It is important for health care professionals who examine children who might have been sexually abused to be able to recognize and interpret any physical signs or laboratory results that might be found. In this review we summarize new data and recommendations concerning documentation of medical examinations, testing for sexually transmitted infections, interpretation of lesions caused by human papillomavirus and herpes simplex virus in children, and interpretation of physical examination findings. Updates to a table listing an approach to the interpretation of medical findings is presented, and reasons for changes are discussed.

Topics: Adolescent; Child; Child Abuse, Sexual; Child, Preschool; Documentation; Female; Genitalia; Humans; Male; Physical Examination; Practice Guidelines as Topic; Sexually Transmitted Diseases

PubMed: 29294380
DOI: 10.1016/j.jpag.2017.12.011

Review

Authors: Thomas H Miller, Jerry E Kruse

Though relatively common, syncope is a complex presenting symptom defined by a transient loss of consciousness, usually accompanied by falling, and with spontaneous recovery. Syncope must be carefully differentiated from other conditions that may cause a loss of consciousness or falling. Syncope can be classified into four categories: reflex mediated, cardiac, orthostatic, and cerebrovascular. A cardiac cause of syncope is associated with significantly higher rates of morbidity and mortality than other causes. The evaluation of syncope begins with a careful history, physical examination, and electrocardiography. Additional testing should be based on the initial clinical evaluation. Older patients and those with underlying organic heart disease or abnormal electrocardiograms generally will need additional cardiac evaluation, which may include prolonged electrocardiographic monitoring, echocardiography, and exercise stress testing. When structural heart disease is excluded, tests for neurogenic reflex-mediated syncope, such as head-up tilt-table testing and carotid sinus massage, should be performed. The use of tests such as head computed tomography, magnetic resonance imaging, carotid and transcranial ultrasonography, and electroencephalography to detect cerebrovascular causes of syncope should be reserved for those few patients with syncope whose history suggests a neurologic event or who have focal neurologic signs or symptoms.

Topics: Algorithms; Diagnosis, Differential; Electrocardiography; Electrophysiologic Techniques, Cardiac; Exercise Test; Humans; Medical History Taking; Physical Examination; Syncope; Tilt-Table Test

PubMed: 16273816
DOI: No ID Found

Review

Authors: E V Hillyer

Pet rabbits are becoming more common, and rabbit owners are demanding quality veterinary care. This article provides a broad overview of pet rabbit medicine, which is a relatively new field compared to laboratory and farm rabbit medicine. The most common differential diagnoses for presenting complaints are summarized in table form. Disease conditions are reviewed individually in the text. Sources of further information on veterinary care of rabbits are listed throughout the text, in an appendix, and in the references.

Topics: Anesthesia; Animal Husbandry; Animals; Animals, Domestic; Eye Diseases; Female; Female Urogenital Diseases; Gastrointestinal Diseases; Infections; Male; Male Urogenital Diseases; Musculoskeletal Diseases; Nervous System Diseases; Physical Examination; Rabbits; Respiratory Tract Diseases; Skin Diseases; Specimen Handling

PubMed: 8109075
DOI: 10.1016/s0195-5616(94)50002-0

Authors: Giovanni Ferrara, Venkata Satish Kolli, Stefan Arnaudov...

A 35-year-old man stopped breathing after injecting a large dose of heroin. He subsequently received cardiopulmonary resuscitation from friends. He arrived to accident and emergency department with Glasgow Coma Scale of 13. On examination, he had distended and tense abdomen. CT Thorax, Abdomen, and Pelvis confirmed massive tension pneumoperitoneum. A 14 Fr intravenous cannula was inserted through the umbilicus to relieve the intra-abdominal pressure. An emergency laparotomy showed petechia along the anterior gastric wall, haematoma of lesser omentum but showed no evidence of gastrointestinal perforation or organ injury. Air leak test performed by insufflating air into the stomach via nasogastric tube and abdomen filled with normal saline showed no leak. On-table oesophagogastroduodenoscopy showed mild oesophagitis and petechia of cardiac gastric mucosa. He was treated with intravenous antibiotics and discharged on the fifth postoperative day with adequate analgesia.

Topics: Abdominal Cavity; Adult; Analgesia; Anti-Bacterial Agents; Cannula; Cardiopulmonary Resuscitation; Decompression, Surgical; Drug Overdose; Heroin; Humans; Laparotomy; Male; Peritonitis; Pneumoperitoneum; Radiography, Abdominal; Tomography, X-Ray Computed; Treatment Outcome

PubMed: 29386215
DOI: 10.1136/bcr-2017-223069

Authors: Eugenie Waters

Topics: Examination Tables; Humans

PubMed: 33077455
DOI: No ID Found