DOCSLIB.ORG

Screening for Developmental Dysplasia of the Hip

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Screening for Developmental Dysplasia of the Hip Evidence Synthesis Number 42 Screening for Developmental Dysplasia of the Hip U.S. Department of Health and Human Services Agency for Healthcare Research and Quality www.ahrq.gov This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied. AHRQ is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The information helps health care decisionmakers—patients and clinicians, health system leaders, and policymakers—make more informed decisions and improve the quality of health care services. Evidence Synthesis Number 42 Screening for Developmental Dysplasia of the Hip Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 http://www.ahrq.gov Contract No. 290-02-0024 Task No. 2 Technical Support of the U.S. Preventive Services Task Force Prepared by: Oregon Evidence-based Practice Center Oregon Health and Science University 3181 SW Sam Jackson Park Road Portland, Oregon 97239 Scott Shipman, MD, MPH, Principal Investigator Mark Helfand, MD, MPH, Co-Investigator Peggy Nygren, MA, Research Associate Christina Bougatsos, Research Assistant March 2006 Preface The agency for Healthcare Research and Quality (AHRQ) sponsors the development of Evidence Syntheses through its Evidence-based Practice Program. With guidance from the U.S. Preventive Services Task Force (USPSTF)* and input from Federal partners and primary care specialty societies, the Evidence-based Practice Center at the Oregon Health & Science University systematically reviews the evidence of the effectiveness of a wide range of clinical preventive services, including screening, counseling, and chemoprevention, in the primary care setting. The Evidence Syntheses— comprehensive reviews of the scientific evidence on the effectiveness of particular clinical preventive services—serve as the foundation for the recommendations of the USPSTF, which provide age- and risk-factor-specific recommendations for the delivery of these services in the primary care setting. Details of the process of identifying and evaluating relevant scientific evidence are described in the “Methods” section of each Evidence Synthesis. The evidence Syntheses document the evidence regarding the benefits, limitations, and cost-effectiveness of a broad range of clinical preventive services and will help further awareness, delivery, and coverage of preventive care as an integral part of quality primary health care. AHRQ disseminates the Evidence Syntheses on the AHRQ Web site (http://www.ahrq.gov/clinic/uspstfix.htm) along with recommendations of the USPSTF. The Recommendation Statements are also available through the National Guideline Clearinghouse (http://www.ngc.gov). We welcome written comments on this Evidence Synthesis. Comments may be sent to: Director, Center fro Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850. Carolyn Clancy, M.D. Helen Burstin, M.D., M.P.H. Director Director Agency for Healthcare Research and Center fro Primary Care, Prevention, and Quality Clinical Partnerships *The USPSTF is an independent panel of experts in primary care and prevention first convened by the U.S. Public Health Service in 1984. The USPSTF systematically reviews the evidence on the effectiveness of providing clinical preventive services—including screening, counseling, and chemoprevention—in the primary care setting. AHRQ convened the USPSTF in November 1998 to update existing Task Force recommendations and to address new topics. Acknowledgements This evidence synthesis was funded by the Agency for Healthcare Research & Quality (AHRQ) for the U.S. Preventive Services Task Force (USPSTF). The investigators thank, Ronald Turker, MD, for serving as a consultant, the USPSTF liaisons, Carol Loveland-Cherry, PhD, RN, Leon Gordis, MD, MPH, DrPH, Virginia Moyer, MD, MPH, and Barbara Yawn, MD, MSc, the AHRQ Medical Officer, Iris Mabry, MD, expert reviewers listed in the Appendix of this report for commenting on draft versions, Andrew Hamilton, MLS, MS for conducting the literature searches, and Miranda Walker for assisting with the manuscript. Requests for Reprints Reprints are available from the AHRQ Web site at www.ahrq.gov (click on Preventive Services). Disclaimer The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services. Contents Screening for Developmental Dysplasia of the Hip Chapter 1. Introduction Burden of Condition ...............................................................................................................................1 Healthcare Interventions.........................................................................................................................3 Prior Recommendations .........................................................................................................................4 Scope of Evidence Synthesis..................................................................................................................5 Chapter 2. Methods Literature Search Strategy ......................................................................................................................6 Inclusion/Exclusion Criteria...................................................................................................................6 Data Extraction and Synthesis................................................................................................................8 Size of Literature Reviewed ...................................................................................................................8 Chapter 3. Results Previous Systematic Reviews.................................................................................................................9 Key Question 1: Does screening for DDH lead to improved outcomes (including reduced need for surgery and improved functional outcomes such as: gait, physical functioning, activity level, peer relations, family relations, school and occupational performance)?......................11 Key Question 2: Can infants at high risk for DDH be identified, and does this group warrant a different approach to screening than children at average risk?..........................................................13 Key Question 3: Does screening for DDH lead to early identification of children with DDH? .........16 3a: What is the accuracy of clinical examination and ultrasound? ...............................................16 3b: How does the age of the child affect screening parameters? ..................................................23 3c: How does the educational level and training of the screener impact screening?....................24 Key Question 4: What are the adverse effects of screening?...............................................................25 Key Question 5: Does early diagnosis of DDH lead to early intervention, and does early intervention reduce the need for surgery or improve functional outcomes? .......................................26 5a: Is the likelihood of surgical intervention reduced in children diagnosed at an earlier age?.................................................................................................................................................30 Key Question 6: What are the adverse effects of early diagnosis and/or intervention? ......................34 Key Question 7: What cost-effectiveness issues apply to screening for DDH? ..................................35 Chapter 4. Discussion Conclusions and Limitations of the Literature .....................................................................................36 Future Research ....................................................................................................................................39 References ...................................................................................................................................................40 Figures Figure 1. Analytic Framework Figure 2. Key Questions Figure 3. Variation in Late Detection Rate by Screening Method 1978-1996 Figure 4. Variation in Late Detection Rate by Year of Study Publication 1978-1996 Figure 5. Range of Published Rates of Avascular Necrosis & Avascular Necrosis Data Sources Tables Table 1. Previous Recommendations by the American Academy of Pediatrics and the Canadian Task Force for DDH for Newborns and Infants Table 2. Risk Factors Table 3. Population-based Comparative Studies: Clinical Exam Versus Ultrasound Table 4. Randomized Trials of Screening Table 5. Comparison of Screening Approaches Represented in Randomized Controlled Trials Table 6. Intervention Studies with Functional Outcomes Table 7. Summary of Findings of Systematic Evidence Review Appendices Appendix 1. Devices and
Load more

Recommended publications
  • Physical Esxam
    Pearls in the Musculoskeletal Exam Frank Caruso MPS, PA-C, EMT-P Skin, Bones, Hearts & Private Parts 2019 Examination Key Points • Area that needs to be examined, gown your patients - well exposed • Understand normal functional anatomy • Observe normal activity • Palpation • Range of Motion • Strength/neuro-vascular assessment • Special Tests General Exam Musculoskeletal Overview Physical Exam Preview Watch Your Patients Walk!! Inspection • Posture – Erectness – Symmetry – Alignment • Skin and subcutaneous tissues – Swelling – Redness – Masses Inspection • Extremities – Size – Deformities – Enlargement – Alignment – Contour – Symmetry Inspection • Muscles – Bilateral symmetry – Hypertrophy – Atrophy – Fasciculations – Spasms Palpation • Palpate bones, joints, and surrounding muscles for the following: – Heat – Tenderness – Swelling – Fluctuation – Crepitus – Resistance to pressure – Muscle tone Muscles • Size and strength affected by the following: – Genetics – Exercise – Nutrition • Muscles move joints through range of motion (ROM). Muscle Strength • Compare bilateral muscles – Strength – Symmetry – Equality – Resistance End Feel Think About It!! • The sensation the examiner feels in the joint as it reaches the end of the range of motion of each passive movement • Bone to bone: This is hard, unyielding – normal would be elbow extension. • Soft–tissue approximation: yielding compression that stops further movement – elbow and knee flexion. End Feel • Tissue stretch: hard – springy type of movement with a slight give – toward the end of range of motion – most common type of normal end feel : knee extension and metacarpophalangeal joint extension. Abnormal End Feel • Muscle spasm: invoked by movement with a sudden dramatic arrest of movement often accompanied by pain - sudden hard – “vibrant twang” • Capsular: Similar to tissue stretch but it does not occur where one would expect – range of motion usually reduced.
    [Show full text]
  • Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal
    National Education Curriculum Specialty Curricula Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal Abdomen and Superficial Structures Including Introductory Pediatric and Musculoskeletal Table of Contents Section I: Biliary ........................................................................................................................................................ 3 Section II: Liver ....................................................................................................................................................... 19 Section III: Pancreas ............................................................................................................................................... 35 Section IV: Renal and Lower Urinary Tract ........................................................................................................ 43 Section V: Spleen ..................................................................................................................................................... 67 Section VI: Adrenal ................................................................................................................................................. 75 Section VII: Abdominal Vasculature ..................................................................................................................... 81 Section VIII: Gastrointestinal Tract (GI) .............................................................................................................. 91
    [Show full text]
  • Screening for Developmental Dysplasia of the Hip
    Screening for Developmental Dysplasia of the Hip: A Systematic Literature Review for the U.S. Preventive Services Task Force Scott A. Shipman, MD, MPH1 Mark Helfand, MD, MPH2 Virginia A. Moyer, MD, MPH3 Barbara P. Yawn, MD, MSc4 1Department of Pediatrics, and 2Oregon Evidence-based Practice Center, Oregon Health & Science University, Portland Ore 3Department of Pediatrics, University of Texas-Houston Health Science Center, Houston TX 4Department of Primary Care Research, Olmsted Medical Center, Rochester Minn Corresponding author: Scott A. Shipman, MD, MPH Department of Pediatrics Oregon Health & Science University 707 SW Gaines Rd., CDRC-P Portland, OR 97239 Phone: (503) 494-6542 FAX: (503) 494-4953 Email: [email protected] Abstract Background: Developmental dysplasia of the hip (DDH) represents a spectrum of anatomic abnormalities that can result in permanent disability. Objective: We sought to gather and synthesize the published evidence regarding screening for DDH by primary care providers. Methods: We performed a systematic review of the literature using a best evidence approach as used by the U.S. Preventive Services Task Force. The review focused on screening relevant to primary care in infants from birth to 6 months of age, and on interventions employed before 1 year of age. Results: The literature on screening and interventions for DDH suffers from significant methodological shortcomings. No published trials directly link screening to improved functional outcomes. Clinical examination and ultrasound identify somewhat different groups of newborns at risk for DDH. A significant proportion of hip abnormalities identified through clinical examination or ultrasound in the newborn period will spontaneously resolve. Very few studies examine the functional outcomes of patients who have undergone therapy for DDH.
    [Show full text]
  • Maternal-Newborn Nursing Demystified Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.156.86] at [07/18/16]
    Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.156.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.156.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission. Maternal-Newborn Nursing Demystified Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.156.86] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission. Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The author and the publisher of this work have checked with sources believed to be reliable in their efforts to provide informa- tion that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the author nor the publisher nor any other party who has been involved in the preparation or publi- cation of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration.
    [Show full text]
  • Case Files Orthopaedic Surgery
    CASE FILES® Orthopaedic Surgery Eugene C. Toy, MD Timothy T. Roberts, MD Vice Chair of Academic Affairs, Resident of Orthopaedic Surgery Department of Obstetrics and Division of Orthopaedic Surgery Gynecology Albany Medical Center The John S. Dunn, Senior Academic Albany, New York Chair and Program Director The Methodist Hospital Ob/Gyn Joshua S. Dines, MD Residency Program Orthopaedic Surgeon Houston, Texas Sports Medicine and Shoulder Service Clerkship Director, Clinical Professor Hospital for Special Surgery Department of Obstetrics and Gynecology New York, New York The University of Texas—Houston Assistant Professor of Orthopaedic Surgery Medical School Weill Cornell Medical College Houston, Texas New York, New York Andrew J. Rosenbaum, MD Resident of Orthopaedic Surgery Division of Orthopaedic Surgery Albany Medical Center Albany, New York New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2013 by McGraw-Hill Education, LLC. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-179029-1 MHID: 0-07-179029-2 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-179030-7, MHID: 0-07-179030-6. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefi t of the trademark owner, with no intention of infringement of the trademark.
    [Show full text]
  • Developmental Dysplasia of the Hip of the Dysplasia
    Developmental Dysplasia of the Hip Developmental Dysplasia of the Hip Anastacio Kotzias-Neto, MD Anastacio Kotzias-Neto, Bowen, MD J. Richard J. Richard Bowen, MD Anastacio Kotzias-Neto, MD Published by www.datatrace.com Data Trace Publishing Company DEVELOPMENTAL DYSPLASIA OF THE HIP By J. Richard Bowen, MD Anastacio Kotzias-Neto, MD Frontmatter.pmd 1 3/3/2006, 7:21 PM Copyright © 2006 Data Trace Publishing Company All rights reserved, First Edition Printed in the United States of America Published by Data Trace Publishing Company P.O. Box 1239 Brooklandville, Maryland 21022-9978 410-494-4994 Fax: 410-494-0515 ISBN 1-57400-108-6 Library of Congress Cataloging-in-Publication Data Developmental dysplasia of the hip / by J. Richard Bowen, Anastacio Kotzias-Neto.— 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 1-57400-108-6 1. Hip joint—Dislocation—Treatment. 2. Hip joint—Dislocation—Surgery. 3. Pediatric orthopedics. [DNLM: 1. Hip Dislocation, Congenital—surgery. 2. Hip Dislocation, Congenital—therapy. 3. Orthopedic Procedures. WE 860 B786d 2006] I. Kotzias-Neto, Anastacio. II. Title. RD772.B69 2006 617.5'81—dc22 2005034950 Frontmatter.pmd 2 3/3/2006, 7:21 PM CONTENTS CHAPTER 1: INTRODUCTION . 1 DISEASE HISTORY OF DDH . 1 EMBRYOLOGY . 13 ETIOLOGY . 18 INCIDENCE . 22 ANATOMY OF THE HIP . 24 RADIOGRAPHIC MEASUREMENTS . 31 BLOOD AND NERVE SUPPLY TO THE HIP . 41 CHAPTER 2: THE NATURAL HISTORY OF DDH . 47 NATURAL HISTORY OF DYSPLASIA WITHOUT SUBLUXATION . 47 NATURAL HISTORY OF SUBLUXATION . 49 NATURAL HISTORY OF COMPLETE DISLOCATION . 50 CHAPTER 3: DIAGNOSIS OF DDH . 53 EARLY DIAGNOSIS (BIRTH TO 3 MONTHS OF AGE) .
    [Show full text]
  • 5. Developmental Dysplasia of Hip 5.1 Introduction Developmental Dysplasia of the Hip (DDH) Is a Condition That Affects the Neonatal and Infant Hip Joint
    5. Developmental Dysplasia of Hip 5.1 Introduction Developmental Dysplasia of the Hip (DDH) is a condition that affects the neonatal and infant hip joint. DDH is a term used to describe a spectrum of abnormalities affecting the relationship of the femoral head (top part of thigh bone) to the acetabulum (socket). In many circumstances, symptoms of DDH may be present at birth, however at times it may resolve within the first weeks of life. Alternatively, the hip may be stable at birth and develop an abnormality later hence the use of the term Developmental Dysplasia of the Hip (DDH), rather than Congenital Dysplasia of the Hip (CDH), as this condition was previously known. These may include an immature hip, a hip with mild acetabular dysplasia, a hip that is dislocatable, a hip that is subluxated, or a hip that is frankly dislocated. The identification of risk factors, including breech presentation and family history, should heighten a physician’s suspicion of developmental dysplasia of the hip. Diagnosis is made by physical examination. Palpable hip instability, unequal leg lengths, and asymmetric thigh skinfolds may be present in newborns with a hip dislocation, whereas gait abnormalities and limited hip abduction are more common in older children. Hip dysplasia refers to an abnormality in the size, shape, orientation, or organization of the femoral head, acetabulum, or both. RESOURCE MATERIAL: Rashtriya Bal Swasthya Karyakram (RBSK) | 99 Acetabular dysplasia is characterized by an immature, shallow acetabulum and can result in subluxation or dislocation of the femoral head. In a sub-luxed hip, the femoral head is displaced from its normal position but still makes contact with a portion of the acetabulum.
    [Show full text]
  • Infant with an Abnormal Hip Exam 1. Background: Routine Neonatal Screening for Developmental Dysplasia of the Hip (DDH) Is Very Important in All Newborns
    Infant with an Abnormal Hip Exam 1. Background: Routine neonatal screening for developmental dysplasia of the hip (DDH) is very important in all newborns. DDH refers to abnormal development of the hip where there is instability (dislocatability) of the hip and dysplasia (abnormal shape) of the acetabulum. Physical examination using the Barlow and Ortolani tests are frequently positive in individuals with DDH, however it is not pathognomonic for dysplasia/dislocation of the femoral head in the acetabulum. Rather, the presence of an abnormal physical exam warrants immediate further investigation and possible intervention. This article outlines the epidemiology, risk factors, signs and symptoms, diagnosis, and treatment of DDH as well as its complications and differential diagnoses. 2. Epidemiology and Risk Factors DDH affects one in one thousand live births and most commonly in occurs in otherwise healthy infants. Laxity of the hip and immaturity of the development of the acetabulum is often detected in normal newborns in the first few weeks of life. This laxity resolves in most cases and acetabulum goes on to develop normally. The cause of DDH in most cases is unknown, but presumed to be multifactorial despite many competing theories that attempt to explain its etiology. DDH can however occur in association with other conditions such as Ehlers-Danlos, Down Syndrome and various forms of neuromuscular hip dysplasia. Other causes of DDH are by teratogens during the gestational period. Risk factors for DDH include female gender, breech presentation, and a positive family history of DDH. Girls with a breech presentation are at the highest risk with an estimated risk of 12%.
    [Show full text]
  • View the 2020 Index
    Index A Abruptio placentae, 640 for osteoarthritis, 466 Acid phosphatase in neutrophils, 406 A-a gradient cocaine use, 614 toxicity effects, 485 Acid reflux by age, 668 preeclampsia, 643 toxicity treatment for, 248 H2 blockers for, 399 with oxygen deprivation, 669 Abscesses, 479 Acetazolamide, 252, 552, 608 proton pump inhibitors for, 399 restrictive lung disease, 675 acute inflammation and, 214 pseudotumor cerebri, 521 Acid suppression therapy, 398 Abacavir, 203 brain, 156, 177, 180 Acetoacetate metabolism, 90 Acinetobacter baumannii Abciximab calcification with, 211 Acetone breath, 347 highly resistant bacteria, 198 Glycoprotein IIb/IIIa inhibitors, cold staphylococcal, 116 Acetylation nosocomial infections, 142 438 frontal lobe, 153 chromatin, 34 Acinetobacter spp therapeutic antibodies, 122 Klebsiella spp, 145 drug metabolism, 232 nosocomial infections, 185 thrombogenesis and, 411 liver, 155, 179 histones, 34 Acne, 475, 477 Abdominal aorta lung, 685 posttranslation, 45 danazol, 658 atherosclerosis in, 302 necrosis with, 209 Acetylcholine (ACh) tetracyclines for, 192 bifurcation of, 663 Staphylococcus aureus, 135 anticholinesterase effect on, 240 Acquired hydrocele (scrotal), 652 branches, 363 Toxoplasma gondii, 177 change with disease, 495 Acrodermatitis enteropathica, 71 Abdominal aortic aneurysm, 302 treatment of lung, 192 Clostridium botulinum inhibition Acromegaly, 339 Abdominal pain in unvaccinated children, 186 of release, 138 carpal tunnel syndrome, 459 bacterial peritonitis, 390 Absence seizures opioid analgesics, 551 GH, 329
    [Show full text]
  • Power Practice Provides the Concentrated Practice Students NCLEX-RN: Need to Earn a Top Score
    TEST PREP/NURSING US $24.95 LearningExpress® All the Practice You Need NCLEX-RN to Succeed on the NCLEX-RN! COMPLETE TEST PREPARATION ® Success on the NCLEX-RN is mandatory to become a registered nurse. NCLEX-RN: Power Practice provides the concentrated practice students NCLEX-RN: need to earn a top score. Inside, you will have access to three full-length practice exams—two in the book, one online—based on the official test, with detailed answer explanations for each answer choice. In addition, this : POWER PRACTICE indispensible study guide provides: POWER PRACTICE Powerful Practice to Help You Pass the NCLEX-RN Exam n THREE NCLEX-RN practice exams for effective test preparation n THREE full-length practice NCLEX-RN exams with n Important information about the exam—what’s on it, when it’s given, detailed answer explanations how to register, and how it’s scored n The perfect supplement to any NCLEX-RN review guide n A customized online score report with comprehensive answer Alicia Culleiton explanations Dr. Yvonne Weideman n The LearningExpress Test Preparation System, which includes stress- reducing and time-budgeting tips instantly scored to an Added value—Access FREE NCLEX-RN Practice Online Visit LearningExpress’s Online Practice Center to: NCLEX-RN exam n Access an NLCEX-RN practice exam—FREE n Receive immediate scoring and detailed answer explanations for all questions n Focus your study with a customized diagnostic report and boost your score to guarantee success ® Boost Your Score! Prepare for a Brighter Future FREE ACCESS to an Instantly Scored Online Practice Exam IT’S LIKE HAVING THE TEST IN ADVANCE! NCLEX-RN is a registered trademark of the National Council of State Boards of Nursing (NCSBN), which neither sponsors nor endorses this product.
    [Show full text]
  • Special Tests
    Special Tests Joint Structure/Disorder/Injury Special Test Jaw TMJ Syndrome/Dysfunction Bite/Cotton Roll Test Cervical Spine Alar Ligament Alar Ligament Stress Test Atlantoaxial Joint (C1/2 Dysfunction) Cervical Flexion Rotation Test Autonomic Nervous System Valsalva Maneuver Cervicogenic Headache Cervical Flexion Rotation Test Deep Cervical Flexors Craniocervical Flexion Test Neck Flexor Endurance Test Disc or Facet Dysfunction Compression/Distraction Test Fracture Rotation < 45 degrees Neural Tension Upper Limb Tension Test Radiculopathy Distraction Test Rotation < 60 degrees Spurling’s Test ULPT 1 Transverse Ligament Sharp Purser Test Transverse Ligament Stress Test Vertebrobasilar Artery Insufficiency Neck Extension-Rotation Test Thoracic Spine First Rib Hypomobility Cervical Rotation Lateral Flexion Test Limited Chest Expansion Thoracic Excursion Neural Tension Slump Test Thoracic Outlet Syndrome Adson Maneuver Allen Test Costoclavicular Syndrome Test Halstead Test Roos Test Wright Test (Hyperabduction Test) Lumbar Spine/ Force Closure Problem Supine/Prone ASLR with Muscle Challenge Pelvis Form Closure Problem Supine/Prone ASLR with Manual Stability Innominate (Anteriorly Stuck) Standing March Test Supine to Long Sit (Long à Short) Innominate (Posteriorly Stuck) Forward Bend Test Supine to Long Sit (Short à Long) Instability H and I Test Lumbar Torsion Test Passive Lumbar Extension Test Prone Segmental Instability Test Neural Tension Centralization/Peripheralization Test Femoral Nerve Traction Test Prone Knee Bend Test Slump Test
    [Show full text]
  • View the 2021 Index
    Index A ABO hemolytic disease of newborn, idiopathic intracranial Acinetobacter baumannii A-a gradient 415 hypertension, 540 highly resistant bacteria, 198 by age, 692 Abortion mechanism, use and adverse Acne, 489, 491 in oxygen deprivation, 693 antiphospholipid syndrome, 482 effects, 631 danazol, 682 restrictive lung disease, 699 ethical situations, 276 sulfa drug, 255 tetracyclines for, 192 with oxygen deprivation, 693 methotrexate for, 450 Acetoacetate metabolism, 90 Acquired hydrocele (scrotal), 676 Abacavir Abruptio placentae, 664 Acetylation Acrodermatitis enteropathica, 71 HIV terapy, 203 cocaine use, 638 chromatin, 34 Acromegaly HLA subtype hypersensitivity, 100 preeclampsia, 667 drug metabolism, 234 carpal tunnel syndrome, 470 Abciximab Abscesses, 493 histones, 34 findings, diagnosis and treatment, antiplatelets, 447 acute inflammation and, 215 posttranslation, 45 347 mechanism and clinical use, 447 brain, 156, 180 Acetylcholine (ACh) GH, 337 thrombogenesis and, 421 calcification with, 212 anticholinesterase effect on, 244 GH analogs, 336 Abdominal aorta cold staphylococcal, 116 change with disease, 510 octreotide for, 410 and branches, 373 frontal lobe, 153 Clostridium botulinum inhibition somatostatin analogs for, 336 atherosclerosis in, 310 Klebsiella spp, 145 of release, 138 Actin bifurcation of, 687 Staphylococcus aureus, 135 pacemaker action potential and, cytoskeleton, 48, 61 Abdominal aortic aneurysm, 310 liver, 155, 179 301 muscular dystrophies, 61 Abdominal pain lung, 709 Acetylcholine (ACh) receptor Acting out, 576
    [Show full text]