Supplementary Appendix D: Literature Search Strategy Details
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Chief Complaint
Chief Complaint Please choose the primary reason you are coming to our office. Complaints are listed alphabetically. Please do not select more than 5 complaints. Upper Back: Thigh/Hip: Calf: o Asthma o Arterial insufficiency o Left calf pain o Bronchitis o Left hip pain o Left leg cramps o Emphysema o Left hip tendonitis o Left leg numbness o Left Flank Pain o Left leg cramps o Left leg pain o Midback pain o Left leg numbness o Left leg weakness o Left leg pain o Leg cramps Lower Back: o Left leg weakness o Leg numbness o Fatigue o Left post. thigh pain o Leg weakness o Left flank pain o Left thigh pain o Varicose veins o Low back pain o Sciatica o Venous insufficiency o Low back spasm o Venous insufficiency o Arterial insufficiency o Lumbar arthritis o Right hip pain o Right calf pain o Menstrual cramps o Right hip tendonitis Right leg o Right leg cramps o Nervousness cramps o Right leg numbness o Pain during BM o Right leg numbness o Right leg pain o Right flank pain o Right leg pain o Right leg weakness o Sacroiliac pain o Right leg weakness o Sciatica o Right post. thigh pain Neck: o Stiffness o Right thigh pain o Bronchitis o Whole body pain o Clavicular pain Head: Buttocks: o Cold o Agitation o Bleeding during BM o Coughing o Anxiety attack o Bursitis of hip o Dysphagia o Cold o Gluteal pain o Goiter o Diminished concentration o Hemorrhoids o Hoarseness o Dizziness o Left gluteal pain o Neck pain o Dysphagia o Left hip pain o Neck spasm o Ear pain o Left post. -
Ankylosing Spondylitis
Page 1 of 4 Ankylosing Spondylitis Ankylosing spondylitis (AS) is a form of arthritis. It mainly affects the lower back. Other joints and other parts of the body are sometimes affected. Treatment includes regular exercise and anti-inflammatory drugs. The severity of AS varies from mild to severe. It is mild or moderate in most cases. What is ankylosing spondylitis? Spondylitis means inflammation of the spine. Ankylosing is a word that describes bones that tend to join together (fuse) across a joint. In ankylosing spondylitis (AS), the discs and ligaments of the lower spine become inflamed. The discs and ligaments are the strong tissues that connect the spinal bones (vertebrae) together. The joints between the lower spine and the pelvis (the sacro-iliac joints), and the small facet joints between the vertebrae are also commonly affected. Inflammation around the lower spine that persists long-term can cause scarring. This may, over time, cause some of the vertebrae in the spine to fuse together. In some cases, inflammation occurs in other joints and in other parts of the body outside of the spine (detailed below). Who gets ankylosing spondylitis? AS usually develops in teenagers or young adults. It rarely first develops after the age of 40. It is three times more common in men than women. There may be a family history with two or more members of a family being affected. About 1 in 1000 people in the UK have AS. What causes ankylosing spondylitis? The cause of AS is not known. There is a strong genetic (hereditary) part. Something may 'trigger' AS to develop in people who have an inherited tendency to have it. -
Patellofemoral Pain Syndrome and Chondromalacia: the Effect of Ozone on Pain, Function and Quality of Life. a Non-Randomized Control-Trial
Central JSM Physical Medicine and Rehabilitation Bringing Excellence in Open Access Research Article *Corresponding author Marcos Edgar Fernández-Cuadros, Calle del Ánsar, 44, piso Segundo, CP 28047, Madrid, Spain, Tel: Patellofemoral Pain Syndrome 34-620314558; Email: [email protected]; Submitted: 23 November 2016 and Chondromalacia: The Effect Accepted: 05 December 2016 Published: 06 December 2016 of Ozone on Pain, Function Copyright © 2016 Fernández-Cuadros et al. and Quality of Life. A Non- OPEN ACCESS Keywords Randomized Control-Trial • Patellofemoral pain syndrome • Chondromalacia Marcos Edgar Fernández-Cuadros1,2*, Olga Susana Pérez-Moro1, • Pain and María Jesús Albaladejo-Florin1 • Ozone therapy • Quality of life 1Servicio de Rehabilitación, Hospital Universitario Santa Cristina, Spain 2de Rehabilitación, Fundación, Hospital General Santísima Trinidad, Spain Abstract Objectives: 1) To demonstrate the effectiveness of a treatment protocol with Ozone therapy on pain, function and quality of life in patients with Patellofemoral Pain Syndrome (PFPS) and Chondromalacia; and 2) to apply Ozone as a conservative treatment option with a demonstrable level of scientific evidence. Material and Methods: Prospective quasi-experimental before-after study (non-randomized control-trial) on 41 patients with PFPS and Chondromalacia grade 2 or more, who attended to Santa Cristina’s University Hospital, from January 2012 to November 2016 The protocol consisted of an intra articular infiltration of a medical mixture of Oxygen-Ozone (95% -5%) 20ml, at a 20ug / ml concentration, and a total number of 4 sessions (1 per week). Pain and quality of life were measured by Visual Analogical Scale (VAS) and Western Ontario and Mc Master Universities Index for Osteoarthritis (WOMAC) at the beginning / end of treatment. -
Rotator Cuff Tendon Ruptures and Degeneration As the First Manifestation of Polymyalgia Rheumatica Disease - a Case Report
Open Access Austin Journal of Clinical Case Reports Case Report Rotator Cuff Tendon Ruptures and Degeneration as the First Manifestation of Polymyalgia Rheumatica Disease - A Case Report Bazoukis G1*, Michelongona P2, Papadatos SS1, Pagkalidou E1, Grigoropoulou P1, Fragkou A1 and Abstract Yalouris A1 Polymyalgia Rheumatica (PMR) is a common rheumatic disease of the 1Department of Internal Medicine, General Hospital of elderly. Although it is a well-established disease, its causes and pathophysiology Athens “Elpis”, Greece remain unclear. In our case report we present an 83-year-old female presented 2Department of Internal Medicine, General Hospital of at the emergency department because of fever and diarrhea. Her medical Korinthos, Greece history included a recent orthopedic surgery because of tendons rupture of the *Corresponding author: George Bazoukis, rotator cuff. Her blood exams showed increased inflammatory markers and a Department of Internal Medicine, General Hospital of three-digit ESR. The diagnosis of PMR was set after the exclusion of infectious Athens “Elpis”, Greece and other diseases that mimic PMR symptoms. To the best of our knowledge, it is the first time that rotator cuff tendons rupture and degeneration is the first Received: June 05, 2016; Accepted: August 02, 2016; manifestation of PMR disease. Clinicians should be aware of the degeneration Published: September 08, 2016 of the shoulder and hip extra-articular structures in PMR and they should keep in mind that it can be the first manifestation of the disease. Keywords: Polymyalgia rheumatica; Rotator cuff denegeration; Tendon rupture Introduction and infraspinatus muscles as well as significant tendinopathy of the subscapularis and long head of biceps muscles. -
James Albers, MD Phd Kirsten Gruis, MD Revised 10/2010
James Albers, MD PhD Kirsten Gruis, MD Revised 10/2010 RADICULOPATHY I. Focal Radiculopathy A. Definitions: 1. Pathological process affecting dorsal (sensory) and/or ventral (motor) spinal roots 2. Clinically includes roots, DRG (dorsal root ganglion) and spinal nerves. B. Clinical Characteristics: 1. Pain may be out of proportion to objective deficit. 2. If chronic, radiculopathy can be asymptomatic. 3. Features favoring radiculopathy vs plexopathy/mononeuropathy a. Proximal pain (neck, low back) b. Pain with movement (tilting neck, lumbar extension) c. Pain with cough, sneeze, Valsalva C. Variables in localization: 1. Nerve damage varies in severity 2. Dermatomal and Myotomal distributions overlap: a. Masks objective deficits b. Enlarges positive phenomena (pain) 3. Pain may also be referred. 4. Involvement of multiple roots may confuse localization. 5. Variable anatomy, especially motor 4. If pain reproduced by palpation then higher suspicion for musculoskeletal disorder mimicking radiculopathy (see Table 1 and 2). However, pain to palpation does not exclude a radiculopathy or abnormal EDX test. 5. 32% of patients referred for EMG lab for lumbosacral radiculopathy have a musculoskeletal disorder. Page 1 of 11 Table 1 Musculoskeletal conditions that commonly mimic cervical radiculopathy Condition Clinical symptoms/signs Fibromyalgia syndrome Pain all over, female predominance, often sleep problems, tender to palpation in multiple areas Polymyalgia rheumatica >50 years old, pain and stiffness in neck, shoulder and hips, high erythrocyte -
SODIUM HYALURONATE Policy Number: PHARMACY 059.37 T2 Effective Date: April 1, 2018
UnitedHealthcare® Oxford Clinical Policy SODIUM HYALURONATE Policy Number: PHARMACY 059.37 T2 Effective Date: April 1, 2018 Table of Contents Page Related Policies INSTRUCTIONS FOR USE .......................................... 1 Autologous Chondrocyte Transplantation in the CONDITIONS OF COVERAGE ...................................... 1 Knee BENEFIT CONSIDERATIONS ...................................... 2 Unicondylar Spacer Devices for Treatment of Pain COVERAGE RATIONALE ............................................. 2 or Disability APPLICABLE CODES ................................................. 4 DESCRIPTION OF SERVICES ...................................... 5 CLINICAL EVIDENCE ................................................. 5 U.S. FOOD AND DRUG ADMINISTRATION ................... 10 REFERENCES .......................................................... 12 POLICY HISTORY/REVISION INFORMATION ................ 14 INSTRUCTIONS FOR USE This Clinical Policy provides assistance in interpreting Oxford benefit plans. Unless otherwise stated, Oxford policies do not apply to Medicare Advantage members. Oxford reserves the right, in its sole discretion, to modify its policies as necessary. This Clinical Policy is provided for informational purposes. It does not constitute medical advice. The term Oxford includes Oxford Health Plans, LLC and all of its subsidiaries as appropriate for these policies. When deciding coverage, the member specific benefit plan document must be referenced. The terms of the member specific benefit plan document [e.g., -
Clinical and Radiographic Features of Spondylitic Hip Disease J
Ann Rheum Dis: first published as 10.1136/ard.38.4.332 on 1 August 1979. Downloaded from Annals of the Rheumatic Diseases, 1979, 38, 332-336 Clinical and radiographic features of spondylitic hip disease J. S. MARKS AND K. HARDINGE From the Rheumatology Unit and the Centre for Hip Surgery, Wrightington Hospital, Wigan, Lancs SUMMARY The clinical and radiographic features of hip disease in 76 patients with definite anky- losing spondylitis have been studied. Symptomatic hip involvement occurred late in the course of the disease, with a mean delay after the onset of 12 years in males and 7 years in females. Patients with disease onset before the age of 20 developed hip symptoms at an earlier stage. Associated diseases included uveitis (13 %), colitis (4 %), and psoriasis (4 %). Bilateral concentric loss of hip joint space with a relatively undeformed femoral head was the commonest radiological change (61 %). Localised loss ofjoint space at the upper pole (16 %) was associated with femoral head destruction and a greater degree of osteophytosis, suggesting coincidental or secondary osteoarthrosis. Bony ankylosis of the hips (10%) was present only in women, and the absence of osteophytes, cysts, and bone lesions of the iliac crests and ischial rami suggests that it is a distinct radiographic manifestation of female ankylosing spondylitis. copyright. Ankylosing spondylitis characteristically affects Clinical details obtained from the medical records the sacroiliac joints and the spine, but peripheral included age at onset of disease, site(s) of initial joint involvement occurs in at least 50% of patients symptoms, age at initial hip symptoms, associated during the course of their disease (Polley and diseases, previous medical and surgical treatment, Slocumb, 1947; Wilkinson and Bywaters, 1958; and details of hip surgery during admission. -
Hallux Valgus
MedicalContinuing Education Building Your FOOTWEAR PRACTICE Objectives 1) To be able to identify and evaluate the hallux abductovalgus deformity and associated pedal conditions 2) To know the current theory of etiology and pathomechanics of hallux valgus. 3) To know the results of recent Hallux Valgus empirical studies of the manage- ment of hallux valgus. Assessment and 4) To be aware of the role of conservative management, faulty footwear in the develop- ment of hallux valgus deformity. and the role of faulty footwear. 5) To know the pedorthic man- agement of hallux valgus and to be cognizant of the 10 rules for proper shoe fit. 6) To be familiar with all aspects of non-surgical management of hallux valgus and associated de- formities. Welcome to Podiatry Management’s CME Instructional program. Our journal has been approved as a sponsor of Continu- ing Medical Education by the Council on Podiatric Medical Education. You may enroll: 1) on a per issue basis (at $15 per topic) or 2) per year, for the special introductory rate of $99 (you save $51). You may submit the answer sheet, along with the other information requested, via mail, fax, or phone. In the near future, you may be able to submit via the Internet. If you correctly answer seventy (70%) of the questions correctly, you will receive a certificate attesting to your earned credits. You will also receive a record of any incorrectly answered questions. If you score less than 70%, you can retake the test at no additional cost. A list of states currently honoring CPME approved credits is listed on pg. -
Adult Still's Disease
44 y/o male who reports severe knee pain with daily fevers and rash. High ESR, CRP add negative RF and ANA on labs. Edward Gillis, DO ? Adult Still’s Disease Frontal view of the hands shows severe radiocarpal and intercarpal joint space narrowing without significant bony productive changes. Joint space narrowing also present at the CMC, MCP and PIP joint spaces. Diffuse osteopenia is also evident. Spot views of the hands after Tc99m-MDP injection correlate with radiographs, showing significantly increased radiotracer uptake in the wrists, CMC, PIP, and to a lesser extent, the DIP joints bilaterally. Tc99m-MDP bone scan shows increased uptake in the right greater than left shoulders, as well as bilaterally symmetric increased radiotracer uptake in the elbows, hands, knees, ankles, and first MTP joints. Note the absence of radiotracer uptake in the hips. Patient had bilateral total hip arthroplasties. Not clearly evident are bilateral shoulder hemiarthroplasties. The increased periprosthetic uptake could signify prosthesis loosening. Adult Stills Disease Imaging Features • Radiographs – Distinctive pattern of diffuse radiocarpal, intercarpal, and carpometacarpal joint space narrowing without productive bony changes. Osseous ankylosis in the wrists common late in the disease. – Joint space narrowing is uniform – May see bony erosions. • Tc99m-MDP Bone Scan – Bilaterally symmetric increased uptake in the small and large joints of the axial and appendicular skeleton. Adult Still’s Disease General Features • Rare systemic inflammatory disease of unknown etiology • 75% have onset between 16 and 35 years • No gender, race, or ethnic predominance • Considered adult continuum of JIA • Triad of high spiking daily fevers with a skin rash and polyarthralgia • Prodromal sore throat is common • Negative RF and ANA Adult Still’s Disease General Features • Most commonly involved joint is the knee • Wrist involved in 74% of cases • In the hands, interphalangeal joints are more commonly affected than the MCP joints. -
Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma (A57079)
Local Coverage Article: Billing and Coding: Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma (A57079) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR NAME CONTRACT TYPE CONTRACT JURISDICTION STATE(S) NUMBER Noridian Healthcare Solutions, A and B MAC 01111 - MAC A J - E California - Entire State LLC Noridian Healthcare Solutions, A and B MAC 01112 - MAC B J - E California - Northern LLC Noridian Healthcare Solutions, A and B MAC 01182 - MAC B J - E California - Southern LLC Noridian Healthcare Solutions, A and B MAC 01211 - MAC A J - E American Samoa LLC Guam Hawaii Northern Mariana Islands Noridian Healthcare Solutions, A and B MAC 01212 - MAC B J - E American Samoa LLC Guam Hawaii Northern Mariana Islands Noridian Healthcare Solutions, A and B MAC 01311 - MAC A J - E Nevada LLC Noridian Healthcare Solutions, A and B MAC 01312 - MAC B J - E Nevada LLC Noridian Healthcare Solutions, A and B MAC 01911 - MAC A J - E American Samoa LLC California - Entire State Guam Hawaii Nevada Northern Mariana Created on 09/28/2019. Page 1 of 33 CONTRACTOR NAME CONTRACT TYPE CONTRACT JURISDICTION STATE(S) NUMBER Islands Article Information General Information Original Effective Date 10/01/2019 Article ID Revision Effective Date A57079 N/A Article Title Revision Ending Date Billing and Coding: Injections - Tendon, Ligament, N/A Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma Retirement Date N/A Article Type Billing and Coding AMA CPT / ADA CDT / AHA NUBC Copyright Statement CPT codes, descriptions and other data only are copyright 2018 American Medical Association. -
Clinical Guidelines: Foot / Ankle
Clinical Guidelines: Foot / Ankle Plantar Fasciitis/Heel spurs: Initial Evaluation: History includes usually atraumatic plantar medial heel pain, worst first thing in the morning or after prolonged sitting. Exam includes tenderness with deep palpation of the plantar medial heel. Squeezing the heel bone side to side is NOT tender, but if present could represent a calcaneal stress fracture. X-rays may or may not reveal a heel spur, but the spur is NOT the source of the pain despite podiatry frequently referring to this as “heel spur syndrome.” Follow-up: The plantar fascia is the soft tissue under our foot that runs from the heel to the toes, much like the palm of our hand; it is the sole of our foot. The plantar fascia stretch includes crossing your legs and dorsiflexing the ankle and stretching the toes into extension. This is the most effective stretch. A night splint is imperative for improvement and should be used at night for 6 weeks. Cortisone injections and physical therapy can be helpful. NSAIDS and a frozen water bottle rolled on the plantar foot could be used with the above treatment, but the most effective treatment is a night splint. Referral: 90% of heel pain resolves with non-op treatment, but make a referral to a foot / ankle ortho surgeon with any atypical heel pain or failure of 6-8 weeks of non-operative treatment. Atypical heel pain usually gets an MRI, but classic plantar fasciitis does not. Bunion (hallux valgus): Initial Treatment: Bunion deformity includes a bump on the medial side of the big toe, the big toe going the wrong way, and a widened forefoot. -
Anatomy of the Dog the Present Volume of Anatomy of the Dog Is Based on the 8Th Edition of the Highly Successful German Text-Atlas of Canine Anatomy
Klaus-Dieter Budras · Patrick H. McCarthy · Wolfgang Fricke · Renate Richter Anatomy of the Dog The present volume of Anatomy of the Dog is based on the 8th edition of the highly successful German text-atlas of canine anatomy. Anatomy of the Dog – Fully illustrated with color line diagrams, including unique three-dimensional cross-sectional anatomy, together with radiographs and ultrasound scans – Includes topographic and surface anatomy – Tabular appendices of relational and functional anatomy “A region with which I was very familiar from a surgical standpoint thus became more comprehensible. […] Showing the clinical rele- vance of anatomy in such a way is a powerful tool for stimulating students’ interest. […] In addition to putting anatomical structures into clinical perspective, the text provides a brief but effective guide to dissection.” vet vet The Veterinary Record “The present book-atlas offers the students clear illustrative mate- rial and at the same time an abbreviated textbook for anatomical study and for clinical coordinated study of applied anatomy. Therefore, it provides students with an excellent working know- ledge and understanding of the anatomy of the dog. Beyond this the illustrated text will help in reviewing and in the preparation for examinations. For the practising veterinarians, the book-atlas remains a current quick source of reference for anatomical infor- mation on the dog at the preclinical, diagnostic, clinical and surgical levels.” Acta Veterinaria Hungarica with Aaron Horowitz and Rolf Berg Budras (ed.) Budras ISBN 978-3-89993-018-4 9 783899 9301 84 Fifth, revised edition Klaus-Dieter Budras · Patrick H. McCarthy · Wolfgang Fricke · Renate Richter Anatomy of the Dog The present volume of Anatomy of the Dog is based on the 8th edition of the highly successful German text-atlas of canine anatomy.