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Transient Hip Tenosynovitis

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1. Transient Hip Tenosynovitis

Transient Hip Tenosynovitis Transient Hip Tenosynovitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Transient Hip Tenosynovitis (...) Transient Hip Tenosynovitis Aka: Transient Hip Tenosynovitis , Transient Synovitis , Transient Tenosynovitis of the Hip , Irritable Hip , Toxic Synovitis From Related Chapters II. Etiology Idiopathic III. Epidemiology : Common (8x more common than septic hip in children) Most common cause of limp with under age 10 Peaks ages 3 to 6 years Boys more commonly affected than girls by a 4:1 ratio Unilateral involvement in 95% of cases IV. Pathophysiology Inflammatory of the hip V. Symptoms Follows 3-6 days

2018 FP Notebook

2. Transient Hip Tenosynovitis

Transient Hip Tenosynovitis Transient Hip Tenosynovitis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Transient Hip Tenosynovitis (...) Transient Hip Tenosynovitis Aka: Transient Hip Tenosynovitis , Transient Synovitis , Transient Tenosynovitis of the Hip , Irritable Hip , Toxic Synovitis From Related Chapters II. Etiology Idiopathic III. Epidemiology : Common (8x more common than septic hip in children) Most common cause of limp with under age 10 Peaks ages 3 to 6 years Boys more commonly affected than girls by a 4:1 ratio Unilateral involvement in 95% of cases IV. Pathophysiology Inflammatory of the hip V. Symptoms Follows 3-6 days

2015 FP Notebook

3. Extremity imaging

(Pediatric only) 11 Developmental dysplasia of the hip (Pediatric only) 11 Discoid meniscus (Pediatric only) 11 Tarsal coalition 11 Infection 12 Soft tissue infection 12 Osteomyelitis 12 Septic arthritis 13 Inflammatory Conditions 14 Bursitis 14 Capitellar osteochondritis 14 Epicondylitis 14 Juvenile idiopathic arthritis (Pediatric only) 14 Myositis 15 Plantar fasciitis 15 Tenosynovitis – long head of biceps 15 Trauma 16 Fracture 16 Patellar dislocation – transient (Pediatric only) 17 Patellar sleeve (...) Derangement 20 Adhesive capsulitis (Adult only) 20 Labral tear – hip 20 Labral tear – shoulder 21 Ligament tear – knee 22 Meniscal tear/injury 22 Rotator cuff tear (Adult only) 23 Tendon injuries-foot and ankle 24 Tendon rupture – biceps or triceps 24 Tendon rupture – foot and ankle 25 Triangular fibrocartilage complex tear 25 Ulnar collateral ligament tear (elbow or thumb) 25 Ligament and tendon injuries not listed elsewhere 25 Miscellaneous Joint Conditions 26 Avascular necrosis 26 Chondromalacia

2019 AIM Specialty Health

4. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association

of cases of statin-induced myopathy. 2.1.3. Clinical Approach to Myopathy or Rhabdomyolysis on Statin Therapy Typically myopathy presents within a few months after starting or increasing the dose of a statin or after introduction of an interacting drug. When a patient reports unexplained muscle aches or weakness, it is important for the clinician to inquire about symptom characteristics. Most commonly, patients present with symptoms that are distributed proximally (eg, hip flexor region, upper chest

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2019 American Gastroenterological Association Institute

6. CrackCAST E136 – Bone and Joint Infections

) Unless that Gram stain comes back! See Rosen’s Tables 128.1 and 128.4 in the 9 th Edition Wisecracks [1] What are Kocher’s Criteria Kocher’s Critieria: Used to help the clinician determine whether a child with a limp has bacterial septic arthritis vs. transient (toxic) synovitis, a self-limited reactive swelling of the synovium of the hip associated with a viral illness. Temp > 38.5 Non weight bearing on affected side WBC > 12 ESR > 40 (CRP >20 mg/L) Likelihood of septic arthritis (# of criteria met (...) (cellulitis or abscess) Muscular (infectious myositis or abscess) Tendinous (infectious tendonitis or tenosynovitis) varieties. Classified as: ACUTE = < 2weeks SUB-ACUTE = 2 – 6 weeks CHRONIC > 6 weeks ***Note*** As Rosen’s states: “ The terms osteomyelitis literally means inflammation of the marrow of the bone, but it is colloquially used to refer to infection in any part of the bone.” Majority are secondary to bacterial infections, but can be fungal, viral and parasitic. Major risk factors for ALL BJIs

2017 CandiEM

7. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease

Often present at rest Improved by change in position History of back problems; worse with sitting; relief when supine or sitting Hip arthritis Lateral hip, thigh Aching discomfort After variable degree of exercise Not quickly relieved Improved when not weight bearing Symptoms variable; history of degenerative arthritis Foot/ankle arthritis Ankle, foot, arch Aching pain After variable degree of exercise Not quickly relieved May be relieved by not bearing weight Symptoms variable; may be related

2017 American Heart Association

8. Imaging Program Guidelines: Pediatric Imaging

include: ¾ CT brain and CT sinus for headache ¾ MRI brain and MRA brain for headache ¾ MRI cervical spine and MRI shoulder for pain indications ¾ MRI lumbar spine and MRI hip for pain indications ¾ MRI or CT of multiple spine levels for pain or radicular indications ¾ MRI foot and MRI ankle for pain indications ¾ Bilateral exams, particularly comparison studies There are certain clinical scenarios where simultaneous ordering of multiple imaging studies is consistent with current literature (...) nervous system pathology when suggested by the ophthalmologic exam Vascular indications This section contains indications for aneurysm, cerebrovascular accident/transient ischemic attack, hemorrhage/hematoma, and other vascular abnormalities. Aneurysm ? Screening in asymptomatic, high-risk individuals ? At least two (2) first degree relatives with intracranial aneurysm or subarachnoid hemorrhage ? Presence of a heritable condition which predisposes to intracranial aneurysm (examples include autosomal

2017 AIM Specialty Health

9. CRACKCast E049 – General Principles to Orthopedic Injuries

to transient paralysis and return to function in weeks – months Axonotmesis – crush injury to a nerve – slow nerve healing Neurotmesis – severing of a nerve that requires surgical repair See table 49-4 Light touch is a good screening test, but two-point discrimination is more sensitive (especially for digital nerves). Compare the sensation bilaterally. Consider the O’Riain wrinkle test or the Ninhydrin sweat test for digital nerve injuries. Compartment Syndrome Any # or damage in an osseofascial space (...) ● Signs: Resp. distress, hypoxemia, ARDS Confusion, mental status change suddenly Thrombocytopenia Petechial rash Fever, tachycardia, jaundice Fat seen in the urine in 50% of cases in 3 days post injury Common after Tib/fib fractures (young adults) or hip fractures in the elderly 1-2 days post acute injury or IM nailing Up to 2% in long bone # Up to 10% in multi# pts Treatment Supportive care 20% mortality rate No therapy shown to benefit Fracture blisters Tense bullae from HIGH energy injuries Due

2016 CandiEM

10. Osteoarthritis

Quervain's tenosynovitis — pain is typically over the radial styloid where there is localized swelling and tenderness (rather than the base of the thumb), caused by irritation of thumb tendons where they run through a fibrous sheath. Trigger thumb — there may be pain and a palpable nodule over the palmar aspect of the metacarpophalangeal (MCP) joint, with clicking on flexing the thumb. Hip osteoarthritis Greater trochanteric pain syndrome — suggested by lateral hip pain with tenderness over the greater (...) Osteoarthritis Osteoarthritis - NICE CKS Share Osteoarthritis: Summary Osteoarthritis is a disorder of synovial joints, which occurs when damage triggers repair processes leading to structural changes within a joint. Joint damage may occur through repeated excessive loading and stress of a joint over time, or by injury. Any synovial joint can be involved — most commonly the knees, hips, and small joints of the hand. The clinical features are variable, between people and at different joint sites

2018 NICE Clinical Knowledge Summaries

12. Altim (Cortivazol) - arthritis, osteoarthritis, tendinitis, bursitis, talalgia, carpal tunnel syndrome, Dupuytren's contracture, radiculalgia

(ESCISIT). EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005 May; 64(5): 669-81. 8 Zhang W et al., EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007 Mar; 66(3 (...) ., EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007 Jan; 66(1): 34-45. 12 Ashraf MO, Devadoss VG. Systematic review and meta-analysis on steroid injection therapy for de Quervain's tenosynovitis in adults. Eur J Orthop Surg Traumatol. 2013 Jan 22. 13 HAS, Prise en charge chirurgicale des tendinopathies rompues de la coiffe des rotateurs de

2014 Haute Autorite de sante

15. Reactive Arthritis (Overview)

, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) and other acute-phase (...) analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status are important in treatment. [ ] Educational measures

2014 eMedicine.com

16. Reactive Arthritis (Overview)

, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) and other acute-phase (...) analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status are important in treatment. [ ] Educational measures

2014 eMedicine.com

17. Reactive Arthritis (Overview)

, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) and other acute-phase (...) analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status are important in treatment. [ ] Educational measures

2014 eMedicine.com

18. Reactive Arthritis (Follow-up)

, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) and other acute-phase (...) analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status are important in treatment. [ ] Educational measures

2014 eMedicine.com

19. Reactive Arthritis (Follow-up)

, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) and other acute-phase (...) analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status are important in treatment. [ ] Educational measures

2014 eMedicine.com

20. Arthritis, Conjunctivitis, Urethritis Syndrome (Treatment)

, aortic regurgitation, transient conduction abnormalities, myocarditis, pericarditis); renal (proteinuria, microhematuria, amyloid deposits, immunoglobulin A [IgA] nephropathy) See for more detail. Diagnosis The diagnosis of ReA is clinical, based on the history and physical examination. No laboratory study or imaging finding is diagnostic. The following laboratory studies may be helpful: White blood cell (WBC) and red blood cell (RBC) counts Erythrocyte sedimentation rate (ESR) C-reactive protein (...) with ReA in this study was low, and a valid subgroup analysis was impossible. The presence of hip-joint involvement, an ESR higher than 30, and unresponsiveness to nonsteroidal anti-inflammatory drugs (NSAIDs) probably portend a severe outcome or chronicity in ReA. Previous Next: Patient Education Poor health-related quality of life and impaired daily physical functioning are observed in patients with refractory or chronic ReA, and strategies focused on improving or maintaining functional status

2014 eMedicine Pediatrics

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