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Femoral Neck Stress Fracture

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181. Thoracic Endovascular Aneurysm Repair TEVAR Full Text available with Trip Pro

considered at high risk for symptomatic TAA or acute aortic syndrome, we recommend urgent imaging, usually Computed Tomography Angiography (CTA) due to its speed and ease of use for pre-operative planning. Level of recommendation: Grade 1 (Strong), Quality of Evidence: B (Moderate), 2) if TEVAR is being considered, we recommend fine cut (less than or equal to 0.25 mm) CTA of the entire aorta, as well as the iliac and femoral arteries. CTA of the head/neck is also needed to determine the anatomy (...) ) Recommendation 4 : If TEVAR is being considered, we recommend fine cut (less than or equal to 0.25 mm) CTA of the entire aorta, as well as the iliac and femoral arteries. CTA of the head/neck is also needed to determine the anatomy of the vertebral arteries. Level of recommendation: Grade 1 (Strong), Quality of Evidence: A (High) Recommendation 5: We recommend routine use of three-dimensional centerline reconstruction software for accurate case planning and execution in TEVAR. Level of recommendation: Grade

2020 Society for Vascular Surgery

183. Metastatic Carcinoma and Myeloma of the Femur

. 11. Long Stem Hemiarthroplasty In the absence of reliable evidence, it is the opinion of the workgroup that when treating a femoral neck fracture with hemiarthroplasty, use of a long stem can be associated with increased intra-operative and post-operative complications and should only be used in patients with additional lesions in the femur. Strength of Recommendation: Consensus Description: In the absence of reliable evidence, the clinical practice guideline development group is making (...) be beneficial with appropriately randomized samples, power, and follow up times, examining the intramedullary nail revision rate due to the occurrence of new femoral neck lesions in the setting of metastatic disease and pathological fractures due to diaphyseal lesions • Future studies would be enhanced by the establishment of a multisite registry for the accumulation of prospectively collected data. 15 METHODS The methods used to perform this systematic review were employed to minimize bias and enhance

2020 American Society of Clinical Oncology Guidelines

184. Appropriate Use Criteria: Joint Surgery

loosening of the hip ? Recurrent dislocation of the hip ? Failed internal fixation of a femoral neck fracture ? Unsalvageable failed hip replacement Contraindications Total hip arthroplasty is contraindicated when ANY of the following are present: ? Presence of a skin infection at the surgical site ? Presence of a systemic infection ? Rapidly progressive neurological disease ? Neuropathic joint ? Intraarticular corticosteroid injection within the past 6 weeks in the joint being replaced Total hip (...) significant hip joint damage include neoplasm, femoral fracture, avascular necrosis (osteonecrosis), inflammatory arthritis (e.g., rheumatoid arthritis) and developmental hip dysplasia. This guideline addresses hip arthroplasty when performed as an elective, non-emergent procedure and not as part of the care of an acute fracture (excluding fracture of implant and periprosthetic fracture). Clinical Indications The following general requirements apply to all indications except where they differ from

2020 AIM Specialty Health

185. Appropriate Use Criteria: Nuclear Medicine Imaging

but is usually recommended when MRI cannot be performed or is nondiagnostic. 9, 10 Fracture, when MRI cannot be performed or is nondiagnostic Bone scintigraphy (limited) is considered medically necessary for detection of occult fracture following nondiagnostic radiographs at high-risk/weight bearing sites: ? Femoral neck, proximal femur ? Tibia (anterior/lateral/plateau) ? Great toe sesamoid ? Patella ? Scaphoid ? Lunate ? Talus ? Navicular ? Metatarsal base (second and fifth digits) Rationale Bone (...) scintigraphy is an alternative when serum markers are normal. 16 Pelvic fracture, when MRI cannot be performed or is nondiagnostic Includes sacral insufficiency fracture, stress fracture, and traumatic fracture. Bone scintigraphy (limited) is considered medically necessary in EITHER of the following scenarios: ? Diagnosis or management of sacral insufficiency fracture ? Diagnosis or management of stress fracture or traumatic fracture following nondiagnostic pelvic or sacral radiographs Perioperative

2020 AIM Specialty Health

186. Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

with permission from Mechanick JI, et al. Endocr Pract. 2017;23:1006-1021 (1).6 Postmenopausal Osteoporosis Guidelines, Endocr Pract. 2020;26(Suppl 1) Copyright © 2020 AACE (Grade B; BEL 2). Osteoporosis is also diagnosed based on a T-score of -2.5 or lower in the lumbar spine (antero- posterior), femoral neck, total hip, or 1/3 radius (33% radius), even in the absence of a prevalent fracture (Grade B; BEL 4, upgraded by consensus). When the initial diagnosis of osteoporosis is made according to a T-score (...) ) or osteoporosis (9). The average femoral neck T-score by dual-energy X-ray absorptiometry (DXA) for 75-year-old women is -2.5, meaning that more than half of women age 75 and older meet the criterion for osteoporosis (10). More than 20% of postmenopausal women have prevalent vertebral fractures (11). Although these guidelines focus only on the evaluation and treat- ment of osteoporosis in postmenopausal women, osteo- porosis may affect men as well as women before and after menopause. Q1. How Is Fracture Risk

2020 American Association of Clinical Endocrinologists

187. AACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

supplementary material from (1). Reprinted with permission from Mechanick JI, et al. Endocr Pract. 2017;23:1006-1021 (1). 6 Postmenopausal Osteoporosis Guidelines, Endocr Pract. 2020;26(Suppl 1) Copyright © 2020 AACE (Grade B; BEL 2). Osteoporosis is also diagnosed based on a T-score of -2.5 or lower in the lumbar spine (antero- posterior), femoral neck, total hip, or 1/3 radius (33% radius), even in the absence of a prevalent fracture (Grade B; BEL 4, upgraded by consensus). When the initial diagnosis (...) ) or osteoporosis (9). The average femoral neck T-score by dual-energy X-ray absorptiometry (DXA) for 75-year-old women is -2.5, meaning that more than half of women age 75 and older meet the criterion for osteoporosis (10). More than 20% of postmenopausal women have prevalent vertebral fractures (11). Although these guidelines focus only on the evaluation and treat- ment of osteoporosis in postmenopausal women, osteo- porosis may affect men as well as women before and after menopause. Q1. How Is Fracture Risk

2020 American Association of Clinical Endocrinologists

188. Prevention, Diagnosis, and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults

map of multivariable analyses of pain, prescription drug, and opioid use factors and long-term opioid use* Study PMID Design (Specific Population) Outcome (Per Study) Mean or Median Age (Range) Pain Cause Nonop Pain Tx Nonpain Tx Opioi d Use Opioid Dependence Opioid Amount Opioid Type Al Dabbagh 2016 26707940 68 Longitudinal retrospective (femoral fracture) Earlier discontinuation of opioid prescriptions (undefined) † 75 years (16-102) NS (injuries) Alam 2012 22412106 69 Longitudinal retrospective (...) retrospective (hip fracture) Persistent opioid use (3-6 months) 82 years (NR) NS NS NS (including dementia) NS Loeb 2020 31584849 82 Longitudinal retrospective (prostate cancer) New chronic opioid use (>2 months) 64 years (NR) ? Charlson CI =3 McDermott 2019 30396321 83 Longitudinal retrospective (oropharyngeal cancer) Continuous opioid use at 6 months NR (=66 years) ? (Older) ? (Female) NS NS (Dementia NR) Musich 2019 30401575 84 Longitudinal retrospective (general population) Chronic opioid use >90 days

2020 Effective Health Care Program (AHRQ)

189. Overview of sport-related injuries

that requires swift diagnosis and treatment to prevent irreversible spinal cord injury and long-term disability. Acute spinal cord injury should be suspected in any patient following trauma, particularly when the trauma is to the head or neck and when the patient is unresponsive due to hypotension and has respiratory compromise. Can occur as a result of spine trauma, vertebral compression fracture, intervertebral disc herniation, primary or metastatic spinal tumour, or infection. The resulting spinal cord (...) subluxation or dislocation, labral tears, chondral injuries, and fractures. Chronic/overuse causes include bursitis, tendonitis, athletic pubalgia (sports hernia), osteitis pubis, snapping hip syndrome, and stress fractures. Holderbaum D, Haqqi TM, Moskowitz RW. Genetics and osteoarthritis: exposing the iceberg. Arthritis Rheum. 1999;42:397-405. http://onlinelibrary.wiley.com/doi/10.1002/1529-0131%28199904%2942:3%3C397::AID-ANR1%3E3.0.CO;2-X/pdf http://www.ncbi.nlm.nih.gov/pubmed/10088759?tool

2018 BMJ Best Practice

190. Overview of musculoskeletal pain

/jama/fullarticle/197628 http://www.ncbi.nlm.nih.gov/pubmed/14612481?tool=bestpractice.com Related conditions Condition Description Chronic fibrosing condition characterised by insidious, progressive, and severe restriction of both active and passive shoulder range of motion. Many patients experience shoulder pain, but shoulder pain is not an essential component of adhesive capsulitis. Although other fractures around and including the ankle can occur (such as distal tibial plafond fractures (...) ), the term 'ankle fracture' generally refers to the medial, lateral, or posterior malleolus. An inflammatory arthritis predominantly affecting the sacroiliac joints and axial spine. Inflammatory back pain is the hallmark clinical feature. This is defined as back pain/stiffness, which is worse in the morning and improves with exercise. Injury typified by sudden, painful, audible 'pop' noise. Patient typically presents with inability to return to activity, joint instability, and rapid development

2018 BMJ Best Practice

192. AIM Clinical Appropriateness Guidelines for Joint Surgery

and placement of a prosthesis anchored to the bone. Numerous implants composed of various biomaterials have been approved by the U.S. Food and Drug Administration (FDA) for use in hip arthroplasty. The goal of the procedure is long-term pain relief and restoration of function. Degenerative joint disease, or osteoarthritis, is the most common condition leading to the need for THA. Other conditions that may also cause significant hip joint damage include neoplasm, femoral fracture, avascular necrosis (...) Surgery 21 3. Department of Veterans Affairs DoDN-SMoHaKOWG, VA/DoD clinical practice guideline for the non-surgical management of hip and knee osteoarthritis., (2014) Washington DC, 126. 4. Goyal N, Chen AF, Padgett SE, et al. Otto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip Arthroplasty. Clinical orthopaedics and related research. 2017;475(2):364-72. 5. Hagel A, Siekmann H, Delank KS. Periprosthetic femoral fracture - an interdisciplinary challenge. Dtsch

2019 AIM Specialty Health

193. Extremity imaging

scenario: ? Evaluation of acute shoulder pain following initial radiographs when imaging is required to establish the diagnosis and the patient is a candidate for corticosteroid or anesthetic injection IMAGING STUDY - MRI upper extremity joint Imaging of the Extremities Copyright © 2019. AIM Specialty Health. All Rights Reserved. 16 - CT may be utilized when MRI contraindicated Trauma Fracture Note: Sites at high risk for fracture include femoral neck/proximal femur, tibia (anterior/lateral), great toe (...) to persons of all ages. See the Coding section for a list of modalities included in these guidelines. Technology Considerations In general, conventional radiographs should be obtained prior to advanced imaging. Computed tomography (CT) is often the preferred modality for evaluation of displaced fractures and subluxations, whereas stress fractures and some incomplete and non-displaced fractures may be better imaged with magnetic resonance imaging (MRI) or radionuclide bone scintigraphy. Tendons

2019 AIM Specialty Health

194. Child Abuse, Elder Abuse, and Intimate Partner Violence

fracture except a parietal fracture that is isolated, unilateral, nondiastatic, linear When more than 1 variable was present, the sensitivity was 96% and the specificity was 46% Predicting Abusive Head Trauma (PredAHT) 17 Hospitalized children under 3 years old presenting with an intracranial injury Cases where etiology of injury was deemed “indeterminate” 6 features are used in the tool: head or neck bruising, seizure, apnea, rib fracture, long bone fracture, retinal hemorrhage With more than 3 (...) trauma cases: Consequence of medical staff missing milder forms of physical abuse. Pediatr Emerg Care. 2008; 24(12): 816-21. 6. Dalton HJ, Slovis T, Helfer RE, Comstock J, Scheurer S, Riolo S. Undiagnosed Abuse in Children Younger Than 3 Years with Femoral Fracture. American Journal of Diseases of Children. 1990; 144(8): 875-8. 7. Sheets LK, Leach ME, Koszewski IJ, Lessmeier AM, Nugent M, Simpson P . Sentinel injuries in infants evaluated for child physical abuse. Pediatrics. 2013; 131(4): 701-7. 8

2019 American College of Surgeons

195. Pharmacological Management of Osteoporosis in Postmenopausal Women Full Text available with Trip Pro

-risk thresholds for other age groups ( ). In the United States, pharmacological therapy is recommended for postmenopausal women with hip or vertebral fractures; those with T-scores of −2.5 or less in the femoral neck, total hip, or lumbar spine; and those with T-scores of −1 to −2.5 and a 10-year probability of ≥20% for major osteoporotic fractures or ≥3% for hip fractures based on the US-adapted FRAX tool ( ). BMD T-score is defined as the number of SDs from the mean BMD of white females age 20 (...) to 29 years in the Third National Health and Nutrition Examination Survey database. For the treatment of osteoporosis, only lumbar spine, total hip, and femoral neck BMD T-scores are usually considered. Data suggest that a recent fracture (within the past 2 years) is a better predictor of imminent fracture risk ( i.e. , risk of fracture within the next 2 years) than is a distant fracture history (>5 years ago) ( , ). This is true for recent vertebral fractures ( , ) as well as nonvertebral fractures

2019 The Endocrine Society

197. Management of Non-neurogenic Male LUTS

and fracture with the initiation of a prostate-selective alpha antagonist: a population based cohort study. BMJ, 2015. 351: h5398. 145. Chang, D.F., et al. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg, 2005. 31: 664. 146. Chatziralli, I.P., et al. Risk factors for intraoperative floppy iris syndrome: a meta-analysis. Ophthalmology, 2011. 118: 730. 147. van Dijk, M.M., et al. Effects of alpha(1)-adrenoceptor antagonists on male sexual function. Drugs, 2006. 66: 287

2019 European Association of Urology

198. Treatment for Acute Pain: An Evidence Map (Draft)

with Fractures 25 Visceral Pain 27 Renal Colic 27 Orofacial Pain 30 Dental Pain 30 Episodic Pain Conditions 30 Acute Migraine 30 Sickle Cell Crisis 37 Discussion 39 Limitations 41 Tables Table 1. Eligible Systematic Reviews and Relevant Studies: All Acute Pain Conditions 10 Table 2. Current Guidelines: Treatment for Postoperative Pain 12 Table 3. Current Guidelines: Treatments for Acute Back Pain 15 Table 4. Current Guidelines: Treatments for Acute Neck Pain 21 Table 5. Current Guidelines: Treatments (...) in Systematic Reviews: Acute Neck Pain 24 Figure 6. Comparisons addressed in Systematic Reviews and New Trials: Fractures 26 Figure 7. Comparisons addressed in Systematic Reviews and New Trials: Renal Colic 29 vii Figure 8. Comparisons addressed in Systematic Reviews: Acute migraine in adults-placebo controlled RCTs in adults 33 Figure 9. Comparisons addressed in Systematic Reviews and New Trials: Acute migraine in adults-active controlled 34 Figure 10. Comparisons addressed in Systematic Reviews and New

2019 Effective Health Care Program (AHRQ)

199. Chronic Pelvic Pain

. Pitfalls of the medical paradigm in chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol, 2000. 14: 525. 82. Sharpe, M., et al. "Unexplained" somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med, 2001. 134: 926. 83. Malykhina, A.P. Neural mechanisms of pelvic organ cross-sensitization. Neuroscience, 2007. 149: 660. 84. Sanford, M.T., et al. The role of environmental stress on lower urinary tract symptoms. Curr Opin Urol, 2017. 27: 268. 85 (...) subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history. Am J Obstet Gynecol, 2006. 195: 554. 90. Meltzer-Brody, S., et al. Trauma and posttraumatic stress disorder in women with chronic pelvic pain. Obstet Gynecol, 2007. 109: 902. 91. Iglesias-Rios, L., et al. Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study. Journal of Women's Health (15409996), 2015. 24: 557. 92. Anderson, A.B

2019 European Association of Urology

200. Treatment for Acute Pain: An Evidence Map

reviews: sickle cell crisis 39 Appendixes Appendix A. Key Informant Discussion Questions Appendix B. Search Strategy Appendix C. Key Informant Call Summaries Appendix D. Intervention Categorization Appendix E. Excluded References Appendix F. Evidence Tables: Postoperative Postdischarge Pain Appendix G. Evidence Tables: Dental Procedures and Oral Surgery Appendix H. Evidence Tables: Acute Back Pain Appendix I. Evidence Tables: Acute Neck Pain Appendix J. Evidence Tables: Fractures Appendix K. Evidence (...) by the Agency for Healthcare Research and Quality (AHRQ) in the statement of work: • Postoperative pain (after discharge from hospital or surgical facility) • Musculoskeletal pain o Back pain o Neck pain o Fracture • Dental pain • Renal colic (episodic pain) • Migraines (episodic pain) • Sickle cell crisis (episodic pain) We will also attempt to map the evidence with regard to specific populations provided by AHRQ in the statement of work as relevant. These subpopulations are important because of specific

2019 Effective Health Care Program (AHRQ)

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