The Journal of Musculoskeletal Medicine Vol 25 No 9

Differentiating low and high ankle sprains

August 28, 2008

Differentiation between low and high ankle sprains iscritical to delivering appropriate care.The classic mechanism for a lowankle sprain is inversion and plantar flexion. A history of ankle ligamentinjury predisposes to recurring sprains. The ankle anterior drawertest may be used to evaluate ligamentous instability. Plain radiographsof the foot and ankle may be indicated in a patient who has an acuteankle injury. Clinicians often use the Ottawa ankle rules to determinethe need for radiographs. In the acute phase, the goals of treatment areto alleviate pain, reduce swelling, and protect the ankle from furtherinjury. NSAIDs and rehabilitation are important components of management.Primary prevention may be possible with strengthening andbalance programs. (J Musculoskel Med. 2008;25:438-443)

Evaluating hip pathology in trochanteric pain syndrome

August 27, 2008

Patients may have greater trochanteric pain syndrome foryears without knowing a defining cause or seeing pain improvement.Pathology within and around the hip joint falls into one of severalcategories, including acute pain with trauma, overuse and repetitivemotion activities, and diseases and degenerative conditions. Pain isdescribed as deep, occasionally sharp aching and stiffness. A uniqueset of factors contribute to the stability and function of the joint. Thedifferential diagnosis for hip pathology includes many entities; consideringreferred pain patterns is important to reduce inappropriatetesting.A compartmental approach to testing for hip pathology helpsorganize causes. Plain radiographs are an important first step inimaging; MRI may help delineate the sources of pain. (J MusculoskelMed. 2008;25:428-436)

Identifying and Managing Dermatomyositis: A Case Report and Review

August 25, 2008

This detailed review desccribes the heterogeneous idiopathic inflammatory myopathies and their mimics, with criteria for classification, an overview of cardiac, pulmonary and malignant comorbidieis, and guidance for treatment.

Pain assessment: An alternative measure

August 23, 2008

A 21-numbered circle visual analog scale (VAS) may be a desirable alternative to the traditional 10-cm horizontal line for pain and patient global estimate on a Multidimensional Health Assessment Questionnaire (MDHAQ).

Disease outcome prediction rule for arthritis validated

August 22, 2008

A prediction rule for the development of rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA) has been validated. The rule accurately estimates the risk of RA in more than 75% of patients with recent-onset UA.