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Differential Diagnosis of Polyarticular Arthritis - American Family Physician

Jul 1, 2015 - Polyarticular arthritis is commonly encountered in clinical settings and has multiple etiologies. The first step is to distinguish between true articular pain and nonarticular or periarticular conditions by recognizing clinical patterns through the history and physical examination. Once...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p35.html

Rheumatologic Tests: A Primer for Family Physicians - American Family Physician

Aug 1, 2018 - Patients with a suspected connective tissue disorder should undergo serologic testing to confirm the diagnosis and, in some cases, to monitor disease activity and predict flares. Patients with suspected systemic lupus erythematosus should be tested for antinuclear antibodies. However, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p164.html

Rheumatoid Arthritis: Common Questions About Diagnosis and Management - American Family...

Apr 1, 2018 - Rheumatoid arthritis is the most commonly diagnosed systemic inflammatory arthritis, with a lifetime prevalence of up to 1% worldwide. Women, smokers, and those with a family history of the disease are most often affected. Rheumatoid arthritis should be considered if there is at least ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p455.html

Osteoarthritis: Rapid Evidence Review - American Family Physician

Apr 15, 2018 - Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography...

American Family Physician : Article

https://www.aafp.org/afp/2018/0415/p523.html

Acute Monoarthritis: Diagnosis in Adults - American Family Physician

Nov 15, 2016 - Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities....

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p810.html

Osteoarthritis: Diagnosis and Treatment - American Family Physician

Jan 1, 2012 - Osteoarthritis is a common degenerative disorder of the articular cartilage associated with hypertrophic bone changes. Risk factors include genetics, female sex, past trauma, advancing age, and obesity. The diagnosis is based on a history of joint pain worsened by movement, which can ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p49.html

Approach to Septic Arthritis - American Family Physician

Sep 15, 2011 - Prompt diagnosis and treatment of infectious arthritis can help prevent significant morbidity and mortality. The acute onset of monoarticular joint pain, erythema, heat, and immobility should raise suspicion of sepsis. Constitutional symptoms such as fever, chills, and rigors are poorly...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p653.html

Shoulder Osteoarthritis: Diagnosis and Management - American Family Physician

Sep 1, 2008 - Osteoarthritis of the shoulder is a gradual wearing of the articular cartilage that leads to pain and stiffness. As the joint surface degenerates, the subchondral bone remodels, losing its sphericity and congruity. The joint capsule also becomes thickened, leading to further loss of ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p605.html

Treatment of Knee Osteoarthritis - American Family Physician

Jun 1, 2011 - Knee osteoarthritis is a common disabling condition that affects more than one-third of persons older than 65 years. Exercise, weight loss, physical therapy, intra-articular corticosteroid injections, and the use of nonsteroidal anti-inflammatory drugs and braces or heel wedges decrease...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1287.html

Arthritis and Joint Pain - American Family Physician

Nov 1, 2019 - This collection features AFP content on arthritis and joint pain, including arthritis, gout, knee osteoarthritis, monoarthritis, osteoarthritis, polyarticular joint pain, Reiter's syndrome, rheumatoid arthritis, septic arthritis, and shoulder osteoarthritis. This collection features AFP...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=77

Treatment of Knee Osteoarthritis - Implementing AHRQ Effective Health Care Reviews - ...

Nov 1, 2018 - What are the clinical effectiveness and harms of cell-based therapies, oral glucosamine and/or chondroitin, physical treatment interventions, weight loss, and home-based and self-management therapies for knee osteoarthritis?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/1101/p603.html

Gout: Diagnosis and Management - Implementing AHRQ Effective Health Care Reviews - ...

Nov 15, 2017 - What is the accuracy of clinical decision tools and imaging for the diagnosis of gout in the primary care setting, and how effective are medications used to treat and prevent gout?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/1115/p668.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

Effectiveness and Safety of Celecoxib for the Treatment of Rheumatoid Arthritis - ...

May 1, 2018 - Compared with placebo, celecoxib improves pain (number needed to treat [NNT] = 4) and clinical symptoms (NNT = 7), but it has no effect on physical function in patients with RA.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0501/p573.html

Pregabalin (Lyrica) for Acute Fibromyalgia Pain - Medicine by the Numbers - American ...

May 1, 2018 - Pregabalin (Lyrica) provides good pain relief to some patients with acute fibromyalgia pain but does not work for most persons. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0501/od1.html

Ultrasound Is Reasonably Accurate in Detecting Synovitis in Patients with Rheumatoid ...

Jun 1, 2018 - In this systematic review of patients with rheumatoid arthritis, ultrasonography was reasonably accurate compared with magnetic resonance imaging (MRI) in detecting synovitis in fingers and wrists. The use of MRI as a reference standard is convenient, but problematic.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0601/p755.html

Lesinurad (Zurampic) for Gout - STEPS - American Family Physician

Mar 15, 2018 - Lesinurad taken in addition to a xanthine oxidase inhibitor reduces serum uric acid levels. However, it does not reduce the likelihood of experiencing a gout flare-up or completely resolving tophi.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0315/p374.html

Acute Gout: ACP Provides Guideline on Diagnosis - Practice Guidelines - American Family...

Dec 1, 2017 - The diagnostic standard for acute gout is joint aspiration with synovial fluid analysis for monosodium urate crystals; however, many patients are seen in a primary care or emergency medicine situation where synovial fluid analysis is rarely performed. The American College of Physicians ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1201/p746.html

Spondyloarthritis: NICE Releases Guidelines on Diagnosis and Treatment - Practice ...

Nov 15, 2017 - Spondyloarthritis comprises inflammatory disorders that have some overlapping characteristics. The National Institute for Health and Care Excellence (NICE) released a guideline on diagnosing and treating spondyloarthritis.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1115/p677.html

Topical NSAIDs for Chronic Musculoskeletal Pain in Adults - Cochrane for Clinicians - ...

Nov 1, 2017 - Topical diclofenac and ketoprofen are slightly more effective than placebo for relieving chronic pain associated with osteoarthritis in adults. Evidence is lacking to determine the effectiveness of topical NSAIDs compared with oral NSAIDs.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1101/p573.html

Dietary Supplements for Osteoarthritis - American Family Physician

Jan 15, 2008 - A large number of dietary supplements are promoted to patients with osteoarthritis and as many as one third of those patients have used a supplement to treat their condition. Glucosamine-containing supplements are among the most commonly used products for osteoarthritis. Although the ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0115/p177.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

Clinical Diagnosis of Gout Without Joint Aspirate - Point-of-Care Guides - American ...

Sep 15, 2016 - Gout is ideally diagnosed through identification of characteristic negatively birefringent crystals under polarized light microscopy in fluid aspirated from end-organ deposits, typically from a joint. However, fewer than 10% of patients with gout see a rheumatologist, and most cases of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0915/p505.html

Diagnosis and Management of Rheumatoid Arthritis - American Family Physician

Sep 15, 2005 - Rheumatoid arthritis is a chronic inflammatory disease characterized by uncontrolled proliferation of synovial tissue and a wide array of multisystem comorbidities. Prevalence is estimated to be 0.8 percent worldwide, with women twice as likely to develop the disease as men. Untreated, ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0915/p1037.html

Diagnosing Acute Monoarthritis in Adults: A Practical Approach for the Family Physician...

Jul 1, 2003 - Acute monoarthritis can be the initial manifestation of many joint disorders. The first step in diagnosis is to verify that the source of pain is the joint, not the surrounding soft tissues. The most common causes of monoarthritis are crystals (i.e., gout and pseudogout), trauma, and ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0701/p83.html

Selective Serotonin Reuptake Inhibitors for Fibromyalgia - Cochrane for Clinicians - ...

Oct 1, 2016 - SSRIs may have a small to moderate effect on pain (number needed to treat [NNT] = 10), global improvement (NNT = 7), and depression (NNT = 13) in patients with fibromyalgia, but the quality of evidence is very low because of bias and small studies. SSRIs do not reduce fatigue related to...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1001/p548.html

All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD - POEMs - ...

Oct 15, 2016 - In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p664.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Hyaluronic Acid Equivalent to Sham Injections in Patients with Knee DJD - POEMs - ...

Apr 15, 2016 - The highest quality studies, which are now fairly plentiful, show that hyaluronic acid injections are only minimally better than sham injections in improving pain and function in patients with knee DJD.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704.html

Exercise for Osteoarthritis of the Knee - Cochrane for Clinicians - American Family ...

Nov 1, 2015 - Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1101/p774.html

Radiographic Assessment of Osteoarthritis - American Family Physician

Jul 15, 2001 - Osteoarthritis is one of the most prevalent and disabling chronic conditions affecting older adults and a significant public health problem among adults of working age. As the bulk of the U.S. population ages, the prevalence of osteoarthritis is expected to rise. Although the incidence ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0715/p279.html

Colchicine for Acute Gout - Cochrane for Clinicians - American Family Physician

Jun 1, 2015 - Low-quality evidence shows that low-dose colchicine (up to 1.8 mg over one hour) is an effective therapy for acute gout.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0601/p759.html

Omega-3 Fatty Acids - American Family Physician

Jul 1, 2004 - Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death caused by cardiac arrhythmias and all-cause mortality in patients with known coronary heart disease. Fatty fish, such as salmon and tuna, and fish oil are rich sources of the omega-3 fatty acids ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0701/p133.html

Treatment of Knee Osteoarthritis: A Clinical Practice Guideline from the AAOS - ...

Jun 1, 2014 - This clinical guideline from the American Academy of Orthopaedic Surgeons (AAOS) updates the one previously published in 2008 and addresses treatment of symptomatic knee osteoarthritis in adults 19 years and older.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/0601/p918.html

Methotrexate Therapy for Rheumatoid Arthritis - Cochrane for Clinicians - American ...

Jan 1, 2015 - Methotrexate monotherapy demonstrated statistically significant and clinically relevant improvement of symptoms and physical function compared with placebo at 12 to 52 weeks. Multiple adverse effects were reported with methotrexate use, and patients were twice as likely to discontinue ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0101/p26.html

Intra-articular Corticosteroid Injections for Osteoarthritis of the Knee - FPIN's ...

Jul 15, 2014 - Intra-articular corticosteroid injections can be used to reduce pain by about 20% in the short term (one to three weeks) in patients with osteoarthritis of the knee.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0715/p115.html

Physical Therapy No Better Than Sham Therapy for Hip Osteoarthritis - POEMs - American ...

Oct 1, 2014 - In this study, physical therapy was no more effective than sham therapy in reducing pain and improving function in adults with hip osteoarthritis.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p497a.html

Platelet-Rich Plasma May Minimally, If at All, Benefit Patients with Knee ...

Apr 1, 2014 - Compared with normal saline or hyaluronic acid, multiple intra-articular injections of platelet-rich plasma significantly improved knee function but did not reduce perceived pain or improve patient satisfaction in adults with symptomatic knee osteoarthritis.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0401/p578.html

Dextrose Prolotherapy Decreases Pain and Stiffness in Knee Degenerative Joint Disease -...

Nov 1, 2013 - Dextrose prolotherapy appears to be more effective in decreasing pain and stiffness, and improving function in patients with knee degenerative joint disease than saline injections and home exercise.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/od1.html

ACR Issues Recommendations on Therapies for Osteoarthritis of the Hand, Hip, and Knee -...

Apr 1, 2013 - The American College of Rheumatology (ACR) has released updated recommendations for the treatment of osteoarthritis of the hip and knee, and has developed new recommendations for the treatment of osteoarthritis of the hand. These recommendations are categorized as strong or conditional.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0401/p515.html

Analgesics for Osteoarthritis - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2013 - What are the comparative effectiveness, benefits, and adverse effects of oral and topical analgesics for osteoarthritis?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2013/0301/p354.html

Osteoarthritis: Diagnosis and Therapeutic Considerations - American Family Physician

Mar 1, 2002 - Osteoarthritis is a common rheumatologic disorder. It is estimated that 40 million Americans and 70 to 90 percent of persons older than 75 years are affected by osteoarthritis. Although symptoms of osteoarthritis occur earlier in women, the prevalence among men and women is equal. In ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p841.html

Osteoarthritis: Current Concepts in Diagnosis and Management - American Family Physician

Mar 15, 2000 - Most patients with osteoarthritis seek medical attention because of pain. The safest initial approach is to use a simple oral analgesic such as acetaminophen (perhaps in conjunction with topical therapy). If pain relief is inadequate, oral nonsteroidal anti-inflammatory drugs or ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0315/p1795.html

Exercise for the Treatment of Knee Osteoarthritis - FPIN's Clinical Inquiries - ...

Sep 1, 2011 - Regular exercise reduces osteoarthritic knee pain and improves functioning.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/0901/od1.html

Opioids for Osteoarthritis of the Knee or Hip - Cochrane for Clinicians - American ...

May 1, 2010 - Compared with placebo, the benefits achieved from opioid therapy are modest in terms of pain relief and improvement in function, and do not outweigh the increase in adverse effects. No single opioid stands out as more effective or safer than the rest.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2010/0501/p1094.html

Osteoarthritis of the Hip - Clinical Evidence Handbook - American Family Physician

Feb 15, 2010 - What are the effects of nondrug, drug, and surgical treatments for osteoarthritis of the hip?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2010/0215/p444.html

Adalimumab (Humira) for the Treatment of Rheumatoid Arthritis - STEPS - American Family...

Dec 15, 2008 - Adalimumab used alone offers little benefit over the traditional first-line agent, methotrexate. However, it increases remission rates when combined with methotrexate in early aggressive rheumatoid arthritis and when combined with traditional DMARDs in those who have not derived benefit...

American Family Physician : STEPS

https://www.aafp.org/afp/2008/1215/p1406.html

Arthroscopic Surgery for Knee Osteoarthritis - Cochrane for Clinicians - American ...

Aug 1, 2008 - Compared with other modalities of treatment such as sham surgery, joint lavage, and joint washout, arthroscopic debridement does not improve outcomes for patients with osteoarthritis of the knee.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0801/p331.html

Predicting Rheumatoid Arthritis Risk in Adults with Undifferentiated Arthritis - ...

May 15, 2008 - Early use of disease-modifying antirheumatic drugs (DMARDs) markedly reduces inflammation and joint destruction associated with RA.1,2 Therefore, with early diagnosis of RA and appropriate use of DMARDs, there is a window of opportunity to change the clinical course of this disabling ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2008/0515/p1451.html

Ophthalmologic Examinations in Children with Juvenile Rheumatoid Arthritis - Practice ...

Jun 15, 2007 - Guidelines on the use and frequency of ophthalmologic examinations in children with juvenile rheumatoid arthritis are available from the American Academy of Pediatrics (AAP).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0615/p1886.html

Glucosamine Treatment for Osteoarthritis - Cochrane for Clinicians - American Family ...

Apr 1, 2006 - This review shows that, compared with placebo, glucosamine sulfate produces a moderate, clinically significant reduction in pain and improvement in function for patients with osteoarthritis. However, study results were not consistent. Most studies in the review used preparations of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0401/p1189.html

Glucosamine and Chondroitin for Osteoarthritis - FPIN's Clinical Inquiries - American ...

Apr 1, 2006 - Glucosamine reduces pain and improves function in patients with knee or hip osteoarthritis.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2006/0401/p1245.html

Cochrane for Clinicians - Feb 1, 2006 - American Family Physician

Feb 1, 2006 - At high dosages, gabapentin is moderately effective for neuropathic pain, although adverse effects are experienced as often as benefit.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0201/p435.html

Cochrane for Clinicians - Feb 1, 2006 - American Family Physician

Feb 1, 2006 - Combined with methotrexate, subcutaneous adalimumab at a dosage of 40 mg every two weeks slows the progression of rheumatoid arthritis at one year. The combination is more effective than adalimumab monotherapy. Limited evidence suggests that adalimumab is also safe and effective when ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2006/0201/p435a.html

Intra-articular Corticosteroid for Treating Osteoarthritis of the Knee - Cochrane for ...

Oct 1, 2005 - An injection of the knee joint with a corticosteroid may improve the patient’s symptoms for up to three weeks after the injection (number needed to treat [NNT]= 3 to 4). There is no evidence that this intervention improves function, and there is little evidence of the benefits ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/1001/p1222.html

Effect of Exercise Intensity on Osteoarthritis - Cochrane for Clinicians - American ...

Sep 1, 2004 - Although land-based exercise improves physical function, there is no evidence that high-intensity cycling offers benefits over low-intensity cycling for patients with osteoarthritis of the knee.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2004/0901/p865.html

Intensive Management of Gestational Diabetes - Cochrane for Clinicians - American ...

Sep 1, 2004 - There is not enough evidence to support dietary or drug treatment in patients with gestational diabetes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2004/0901/p866.html

Is Leflunomide as Safe and Effective in the Treatment of Rheumatoid Arthritis as Other ...

Sep 1, 2003 - Compared with placebo, leflunomide improves clinical outcomes and delays radiologic progression of rheumatoid arthritis. After two years of treatment, leflunomide is as safe as sulfasalazine and more effective. Leflunomide's efficacy and adverse events are similar to those of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2003/0901/p849.html

Advances in the Treatment of Early Rheumatoid Arthritis - Editorials - American Family ...

Sep 15, 2005 - Advertisement << Previous article Next article >> Sep 15, 2005 Issue Editorials Advances in the Treatment of Early Rheumatoid Arthritis EDWARD M. J. VITAL, M.B.CH.B., The General Infirmary at Leeds, Leeds, United Kingdom PAUL EMERY, M.A., M.D., University of Leeds Faculty of Medicine...

American Family Physician : Editorials

https://www.aafp.org/afp/2005/0915/p1002.html

Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid ...

Feb 1, 2004 - The efficacy of COX-2 inhibitors is similar to that of nonselective NSAIDs in reducing the symptoms of rheumatoid arthritis.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2004/0201/p595.html

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