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small fibres are affected. SFN refers to isolated small fibre involvement. About 40-50% of patient with fibromyalgia meet the diagnostic criteria for SFN

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radicular pain, and identifying "red flag" conditions. A decision is then made about whether to go down an investigative pathway to determine the source and cause

fibromyalgia. The peak onset is 20-50 but it can occur at any age. and is about twice as common in women. In clinical practice it is predominantly diagnosed

common structural spinal deformity in children and adolescents. It affects about 2-3% of adolescents, but the prevalence is dependent on the cut-off point

the highest likelihood ratio, but some patients may not be very excited about trying this. Groin pain on hip abduction or adduction, abductor weakness

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the lunocapitate joint. The radial column takes about 75% of load, while the ulnar column takes about 25% of load. Radial and Ulnar Deviation Radial deviation:

topic. Please use your clinical judgement. There is a lot of controversy about examination for posture regarding its validity and reliability. Many clinicians

048. ISSN 1097-6833. PMID 28728811. Check date values in: |date= (help) "About the test | National Screening Unit". www.nsu.govt.nz. Retrieved 2023-03-05

sclerosis experience symptoms resembling TN. Idiopathic TN, constituting about 10% of cases, is diagnosed when no apparent cause for the condition can be

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reflexes Primitive reflexes The reflexes tested during examination come about due to brisk stretch of the muscle, leading to activation of the muscle spindles

is common. See Sacroiliac Joint Precision Treatment for more information about precision treatments for this structure. Main article: Sacroiliac Joint Anatomy

a senior standard (criterion standard, gold standard). To make decisions about patient care the doctor must also comprehend the pre-test probability of

histological confirmation with limb involvement. There were assumptions made about which segment was involved. We now know that sometimes several adjacent levels

vertigo. BPPV can be associated with head trauma but again is best learned about from the external resources. Practice Point Focus on the timing and triggers

and is more common in recreational players. See Hatch et al for discussion about racket grip sizes. Poor prognostic factors High work physical strain, such

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Peripheral nerve fibres when injured can be "sensitised" - i.e. they bring about a intense and prolonged ectopic afferent activity to the central nervous

forces applied at the joint surfaces Tension through muscle forces applied about the joint surfaces. Contact forces larger than muscle forces generally. Combined

the L1 nerve root with a contribution of fibers from the T12 nerve root in about 25% of patients. It provides sensation to the skin of the inguinal region

and number of painful sites. Pain intensity may start to decrease after about 3 weeks of abstinence. However in the surgical literature, postoperative

activity leading to pain perception. A lot is known about possible sources, but not a great amount about actual sources of neck pain. The cause of the pain

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before considering tendinopathy. The common classic sites of enthesopathy about the hip are: Iliopsoas insertion to the lesser trochanter of the femur Rectus

structured mental summary of a doctor's knowledge about a specific disease. It represents a their knowledge about a particular disease, and may be as short as

(plural entheses) is the interface between tendon/ligament and bone. See also about the myotendinous junction, the connection between muscle and tendon The musculoskeletal

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termed noxious. The information about tissue damage is referred to as nociceptive information. Most of what we know about pain relates to the physiology

often reported that there are approximately 7000 rare diseases, of which about 80% are genetic. This figure is an underestimate if you include cancers and

This article is still missing information. Read about the levels of evidence here. ASIPP evidence ratings are preferred when assessing evidence in WikiMSK

bone bruise, ligamentous tear, meniscal tear, and chondral injury. Enquire about the nature of the trauma. Posterior cruciate injuries often occur with a

closely linked to the time of the accident/forces, and the patient is definite about the accident. The pain distribution is highly variable. The pain is significant

muscle filaments to the collagen fibres of the adjoining tendon. See also about entheses, the connection between tendon/ligament and bone. Muscles Synovial

block, and has there is no radiation exposure. The analgesic effect lasts about one week. Theoretically all pain arising from the facet joint, musculature

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studies. Overall the treating doctor can relay optimism, but be guarded about prognosis. A systematic review of 11 studies performed in the US, Australia

musculoskeletal system. The primary purpose is to find objective information about the index condition and it complements the history taking in the process

cancer for nonsmokers.  The relative risk does not provide any information about the absolute risk of the event occurring, but rather the higher or lower

evidence does not support this traditional view. Concerns have been raised about the drift from evidence-based indications, moving from treating permanently

history-taking and the physical exam by defining the problem & sparking ideas about the differential or possible categories of disease. It helps identify important

stic_Decision_Making.pdf Media:Eva2005_What_every_teacher_needs_to_know_about_clinical_reasoning.pdf Media:Monteiro2013_Diagnostic_Reasoning_Where_We've_Been

kinase is usually high, and red blood cell PFK activity is usually reduced by about 50 percent. Patients may have mild hemolytic anemia and mild hyperbilirubinemia

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Sterile cleansing solution Adhesive bandage Patient supine, knee flexed about 90 degrees, with foot flat on the examination table in 30-45 degrees of plantar

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malleolus) is posterior and inferior to the medial portion (medial malleolus)- about 10 degrees in coronal plane AND approximately a 6° angle with the horizontal

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being a tendon of the semispinalis musculature in the lumbar spine. It is about 1-2mm thick. The ligament can be ossified which converts the notch into a

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commercial use, but can be modified. Scapular fractures are rare (incidence: about 10 per 100,000 person-years) and often a consequence of high-energy trauma

needle Insert the needle 1–2 mL into the subcutaneous tissue to a depth of about 4–6 mm. Aspirate to exclude arterial puncture and inject Greater Occipital

surgical procedures, should also be noted. Men should be specifically asked about pain related to sexual activity. Post hernia repair pain can vary greatly

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the researcher who wants to be 95% sure about the outcome of their study is willing to be wrong 5% of the time about the study result. The alpha is the decimal

either strongly or weakly activated by innocuous stimuli. About half of Aδ fibres and about 70% of sensory C fibres are high-threshold units. The mechano-sensitivity

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NMPS. Ask about occupation and any potentially relevant aggravating factors such as sporting activities, driving, prolonged typing, etc. Ask about arm dominance

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levels are not generally required unless there are side-effects, concern about compliance, or breakthrough seizures when used for epilepsy. Also monitor

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COVID-19 through RAT testing. Knowing about the history of medicine can be useful for having a greater understanding about the ideological debates that continue

atlas (C1) rises back up. Flexion-extension is only about 10° (each way), and lateral flexion about 5° (each way). Muscles of the atlas (C1): Levator scapulae:

“fracture line,” as well as the matching appearance in the contralateral knee in about half of all cases. Although non-unions are rare after patellar fractures

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later worsen. Advised to keep active within pain limits, and is reassessed about 10 days later. Repeated injections may be performed Anterior Cutaneous Nerve

small fibres are affected. SFN refers to isolated small fibre involvement. About 40-50% of patient with fibromyalgia meet the diagnostic criteria for SFN

recommendations. Ask about the circumstances of onset, with particular respect to trauma. A spontaneous onset of pain should lead to more careful enquiry about red flag

phalanx bone. Attempt injection. If there is no flow then withdraw the needle about 1mm to achieve flow into the space between the posterior flexor tendon sheath

Multiple synovial joints with strong transverse and alar ligaments provide about half of total movements Movements: C0-1 - nutation, C1-2 - rotation Nerve

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CRP, vitamin D, and/or plain radiographs. Reassure the child and caregiver about the benign nature of the condition. The child should continue usual activities

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should care about the problem Concern: the doctor should take the patient seriously If the patient asks about imaging an explanation is given about why it isn't

ideas (how they perceive their situation), concerns (what they are worried about), and expectations (what they hope to get out of the consultation). It also

keep active within pain limits, and is reassessed about 10 days later. Steroid remains in situ for about 2 weeks. Up to 3-4 injections may be performed before

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