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Pleuritic Chest Pain: Sorting Through the Differential Diagnosis - American Family ...

Sep 1, 2017 - Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p306.html

Unexplained Lymphadenopathy: Evaluation and Differential Diagnosis - American Family ...

Dec 1, 2016 - Lymphadenopathy is benign and self-limited in most patients. Etiologies include malignancy, infection, and autoimmune disorders, as well as medications and iatrogenic causes. The history and physical examination alone usually identify the cause of lymphadenopathy. When the cause is ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p896.html

Ear Pain: Diagnosing Common and Uncommon Causes - American Family Physician

Jan 1, 2018 - Otalgia (ear pain) is a common presentation in the primary care setting with many diverse causes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. Examination of the ear usually reveals abnormal findings in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p20.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Evaluation of Patients with Leukocytosis - American Family Physician

Dec 1, 2015 - An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal ranges for the white blood cell count. A repeat complete blood count with peripheral smear may provide helpful ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1201/p1004.html

Evaluation of Neck Masses in Adults - American Family Physician

May 15, 2015 - Neck masses are often seen in clinical practice, and the family physician should be able to determine the etiology of a mass using organized, efficient diagnostic methods. The first goal is to determine if the mass is malignant or benign; malignancies are more common in adult smokers ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p698.html

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Knee Pain in Adults and Adolescents: The Initial Evaluation - American Family Physician

Nov 1, 2018 - Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p576.html

Evaluation of the Patient with Hip Pain - American Family Physician

Jan 1, 2014 - Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0101/p27.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Dysuria: Evaluation and Differential Diagnosis in Adults - American Family Physician

Nov 1, 2015 - The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p778.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Assessment of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Dec 1, 2013 - Although routine screening for bladder cancer is not recommended, microscopic hematuria is often incidentally discovered by primary care physicians. The American Urological Association has published an updated guideline for the management of asymptomatic microscopic hematuria, which is ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p747.html

Evaluation of the Painful Eye - American Family Physician

Jun 15, 2016 - Eye problems constitute 2% to 3% of all primary care and emergency department visits. Common eye conditions that can cause eye pain are conjunctivitis, corneal abrasion, and hordeolum, and some of the most serious eye conditions include acute angle-closure glaucoma, orbital cellulitis, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p991.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Recurrent Abdominal Pain in Children - American Family Physician

Jun 15, 2018 - Recurrent abdominal pain (RAP) in children is defined as at least three episodes of pain that occur over at least three months and affect the child’s ability to perform normal activities. RAP is most often considered functional (nonorganic) abdominal pain, but an organic cause is found ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p785.html

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

Chronic Cough: Evaluation and Management - American Family Physician

Nov 1, 2017 - Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p575.html

Evaluation and Management of Neck Masses in Children - American Family Physician

Mar 1, 2014 - Neck masses in children usually fall into one of three categories: developmental, inflammatory/reactive, or neoplastic. Common congenital developmental masses in the neck include thyroglossal duct cysts, branchial cleft cysts, dermoid cysts, vascular malformations, and hemangiomas. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p353.html

Clinical Evaluation of Bleeding and Bruising in Primary Care - American Family Physician

Feb 15, 2016 - Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The International Society on Thrombosis and Hemostasis has developed a bleeding assessment tool that can be used to indicate ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0215/p279.html

Evaluation and Diagnosis of Wrist Pain: A Case-Based Approach - American Family Physician

Apr 15, 2013 - Patients with wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite traumatic event. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most commonly fractured carpal bone. Conventional radiography alone can miss up ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p568.html

Tremor: Sorting Through the Differential Diagnosis - American Family Physician

Feb 1, 2018 - Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p180.html

Outpatient Diagnosis of Acute Chest Pain in Adults - American Family Physician

Feb 1, 2013 - Approximately 1 percent of primary care office visits are for chest pain, and 1.5 percent of these patients will have unstable angina or acute myocardial infarction. The initial goal in patients presenting with chest pain is to determine if the patient needs to be referred for further ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0201/p177.html

Evaluation of Chronic Diarrhea - American Family Physician

Nov 15, 2011 - Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1119.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Diagnosis of Heel Pain - American Family Physician

Oct 15, 2011 - Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p909.html

Causes and Evaluation of Chronic Dyspnea - American Family Physician

Jul 15, 2012 - Chronic dyspnea is shortness of breath that lasts more than one month. The perception of dyspnea varies based on behavioral and physiologic responses. Dyspnea that is greater than expected with the degree of exertion is a symptom of disease. Most cases of dyspnea result from asthma, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0715/p173.html

The Generalized Rash: Part I. Differential Diagnosis - American Family Physician

Mar 15, 2010 - Physicians often have difficulty diagnosing a generalized rash because many different conditions produce similar rashes, and a single condition can result in different rashes with varied appearances. A rapid and accurate diagnosis is critically important to make treatment decisions, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0315/p726.html

Diagnostic Imaging of Acute Abdominal Pain in Adults - American Family Physician

Apr 1, 2015 - Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p452.html

Dizziness: A Diagnostic Approach - American Family Physician

Aug 15, 2010 - Dizziness accounts for an estimated 5 percent of primary care clinic visits. The patient history can generally classify dizziness into one of four categories: vertigo, disequilibrium, presyncope, or lightheadedness. The main causes of vertigo are benign paroxysmal positional vertigo, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p361.html

Prolonged Febrile Illness and Fever of Unknown Origin in Adults - American Family ...

Jul 15, 2014 - Fever of unknown origin has been described as a febrile illness (temperature of 101°F [38.3°C] or higher) for three weeks or longer without an etiology despite a one-week inpatient evaluation. A more recent qualitative definition requires only a reasonable diagnostic evaluation. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p91.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

A Systematic Approach to the Evaluation of a Limping Child - American Family Physician

Nov 15, 2015 - A limp is defined as a deviation from a normal age-appropriate gait pattern resulting in an uneven, jerky, or laborious gait. It can be caused by pain, weakness, or deformity as a result of a variety of conditions. Transient synovitis is the most common diagnosis. Other causes of acute ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p908.html

Evaluation of Fever in Infants and Young Children - American Family Physician

Feb 15, 2013 - Febrile illness in children younger than 36 months is common and has potentially serious consequences. With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p254.html

Diagnostic Approach to Patients with Tinnitus - American Family Physician

Jan 15, 2014 - Tinnitus, a common symptom encountered in family medicine, is defined as the perception of noise in the absence of an acoustic stimulus outside of the body. Because tinnitus is a symptom and not a disease, its underlying cause must be determined to best help patients. Although tinnitus ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0115/p106.html

Evaluation of Scrotal Masses - American Family Physician

May 1, 2014 - Scrotal masses are caused by a variety of disorders, ranging from benign conditions to those requiring emergent surgical intervention. Painful scrotal masses require urgent evaluation. Characteristics that suggest testicular torsion include rapid symptom onset, nausea and vomiting, high...

American Family Physician : Article

https://www.aafp.org/afp/2014/0501/p723.html

Left Lower-Quadrant Pain: Guidelines from the American College of Radiology ...

Oct 1, 2010 - The differential diagnosis of left lower-quadrant pain includes gastrointestinal, gynecologic, and renal/ureteric pathology. Imaging is helpful in evaluating left lower-quadrant pain, and is generally guided by the clinical presentation. Acute sigmoid diverticulitis should be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1001/p766.html

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.html

Diagnostic Approach to Chronic Constipation in Adults - American Family Physician

Aug 1, 2011 - Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0801/p299.html

Evaluation of Nausea and Vomiting: A Case-Based Approach - American Family Physician

Sep 15, 2013 - In the absence of acute abdominal pain, significant headache, or recent initiation of certain medications, acute nausea and vomiting is usually the result of self-limited gastrointestinal infections. Nausea and vomiting is also a common adverse effect of radiation therapy, chemotherapy,...

American Family Physician : Article

https://www.aafp.org/afp/2013/0915/p371.html

A Diagnostic Approach to Pruritus - American Family Physician

Jul 15, 2011 - Pruritus can be a symptom of a distinct dermatologic condition or of an occult underlying systemic disease. Of the patients referred to a dermatologist for generalized pruritus with no apparent primary cutaneous cause, 14 to 24 percent have a systemic etiology. In the absence of a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0715/p195.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Oct 15, 2009 - Adnexal masses represent a spectrum of conditions from gynecologic and nongynecologic sources. They may be benign or malignant. The initial detection and evaluation of an adnexal mass requires a high index of suspicion, a thorough history and physical examination, and careful attention ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p815.html

Diagnosis of Ear Pain - American Family Physician

Mar 1, 2008 - Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary...

American Family Physician : Article

https://www.aafp.org/afp/2008/0301/p621.html

Evaluation of Acute Pelvic Pain in Women - American Family Physician

Jul 15, 2010 - Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p141.html

Evaluation of the Patient with Chronic Cough - American Family Physician

Oct 15, 2011 - Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. Patients who are taking an angiotensin-converting enzyme inhibitor should switch to a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p887.html

Fever in Returning Travelers: A Case-Based Approach - American Family Physician

Oct 15, 2013 - Overall, 3% to 19% of travelers to the developing world will return to the United States with fever or will develop fever within weeks of their return. When evaluating the returning traveler with fever, it is important to know which pretravel immunizations the patient received; which ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1015/p524.html

Evaluation of Nausea and Vomiting - American Family Physician

Jul 1, 2007 - A comprehensive history and physical examination can often reveal the cause of nausea and vomiting, making further evaluation unnecessary. Acute symptoms generally are the result of infectious, inflammatory, or iatrogenic causes. Most infections are self-limiting and require minimal ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0701/p76.html

The Generalized Rash: Part II. Diagnostic Approach - American Family Physician

Mar 15, 2010 - Although it is important to begin the evaluation of generalized rash with an inclusive differential diagnosis, the possibilities must be narrowed down by taking a focused history and looking for key clinical features of the rash. Part I of this two-part article lists the common, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0315/p735.html

Outpatient Approach to Palpitations - American Family Physician

Jul 1, 2011 - Palpitations are a common problem seen in family medicine; most are of cardiac origin, although an underlying psychiatric disorder, such as anxiety, is also common. Even if a psychiatric comorbidity does exist, it should not be assumed that palpitations are of a noncardiac etiology. ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p63.html

Fatigue: An Overview - American Family Physician

Nov 15, 2008 - Fatigue, a common presenting symptom in primary care, negatively impacts work performance, family life, and social relationships. The differential diagnosis of fatigue includes lifestyle issues, physical conditions, mental disorders, and treatment side effects. Fatigue can be classified...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1173.html

Evaluation of Scrotal Masses - American Family Physician

Nov 15, 2008 - Scrotal masses can represent a wide range of medical issues, from benign congenital conditions to life-threatening malignancies and acute surgical emergencies. Having a clear understanding of scrotal anatomy allows the examiner to accurately identify most lesions. Benign lesions such as...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1165.html

Initial Evaluation of Vertigo - American Family Physician

Jan 15, 2006 - Benign paroxysmal positional vertigo, acute vestibular neuronitis, and Meniere's disease cause most cases of vertigo; however, family physicians must consider other causes including cerebrovascular disease, migraine, psychological disease, perilymphatic fistulas, multiple sclerosis, and...

American Family Physician : Article

https://www.aafp.org/afp/2006/0115/p244.html

Bleeding and Bruising: A Diagnostic Work-up - American Family Physician

Apr 15, 2008 - Primary care physicians are often asked about easy bruising, excessive bleeding, or risk of bleeding before surgery. A thorough history, including a family history, will guide the appropriate work-up, and a physical examination may provide clues to diagnosis. A standardized bleeding ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1117.html

Jaundice in the Adult Patient - American Family Physician

Jan 15, 2004 - Jaundice in an adult patient can be caused by a wide variety of benign or life-threatening disorders. Organizing the differential diagnosis by prehepatic, intrahepatic, and posthepatic causes may help make the work-up more manageable. Prehepatic causes of jaundice include hemolysis and ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0115/p299.html

Evaluation of the Patient with Muscle Weakness - American Family Physician

Apr 1, 2005 - Muscle weakness is a common complaint among patients presenting to family physicians. Diagnosis begins with a patient history distinguishing weakness from fatigue or asthenia, separate conditions with different etiologies that can coexist with, or be confused for, weakness. The pattern ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1327.html

Diagnosing Night Sweats - American Family Physician

Mar 1, 2003 - Night sweats are a common outpatient complaint, yet literature on the subject is scarce. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. While these diseases remain ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0301/p1019.html

Hoarseness in Adults - American Family Physician

Aug 15, 2009 - Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0815/p363.html

Approach to the Adult Patient with Fever of Unknown Origin - American Family Physician

Dec 1, 2003 - Fever of unknown origin (FUO) in adults is defined as a temperature higher than 38.3 degrees C (100.9 degrees F) that lasts for more than three weeks with no obvious source despite appropriate investigation. The four categories of potential etiology of FUO are classic, nosocomial, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1201/p2223.html

A Clinical Approach to Diagnosing Wrist Pain - American Family Physician

Nov 1, 2005 - A detailed history alone may lead to a specific diagnosis in approximately 70 percent of patients who have wrist pain. Patients who present with spontaneous onset of wrist pain, who have a vague or distant history of trauma, or whose activities consist of repetitive loading could be ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1753.html

The Diagnosis of Wheezing in Children - American Family Physician

Apr 15, 2008 - Wheezing in children is a common problem encountered by family physicians. Approximately 25 to 30 percent of infants will have at least one wheezing episode, and nearly one half of children have a history of wheezing by six years of age. The most common causes of wheezing in children ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1109.html

Evaluation of Back Pain in Children and Adolescents - American Family Physician

Dec 1, 2007 - Back pain is fairly prevalent in healthy children and adolescents. When children or adolescents seek medical care for back pain, it is highly likely that underlying pathology will be identified. Common causes of back pain include nonspecific pain or muscle strain, herniated disk, ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1201/p1669.html

Diagnostic Approach to Polyarticular Joint Pain - American Family Physician

Sep 15, 2003 - Identifying the cause of polyarticular joint pain can be difficult because of the extensive differential diagnosis. A thorough history and a complete physical examination are essential. Six clinical factors are helpful in narrowing the possible causes: disease chronology, inflammation, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1151.html

Radiologic Evaluation of Chronic Neck Pain - American Family Physician

Oct 15, 2010 - For many years, there were no guidelines for evaluating patients with chronic neck pain. However, in the past 15 years, considerable research has led to recommendations regarding whiplash-associated disorders. This article summarizes the American College of Radiology Appropriateness ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1015/p959.html

Evaluation of Patients Presenting with Knee Pain: Part II. Differential Diagnosis - ...

Sep 1, 2003 - Knee pain is a common presenting complaint with many possible causes. An awareness of certain patterns can help the family physician identify the underlying cause more efficiently. Teenage girls and young women are more likely to have patellar tracking problems such as patellar ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0901/p917.html

The Adult Neck Mass - American Family Physician

Sep 1, 2002 - Family physicians frequently encounter neck masses in adult patients. A careful medical history should be obtained, and a thorough physical examination should be performed. The patient's age and the location, size, and duration of the mass are important pieces of information. ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p831.html

Diagnostic Approach to Palpitations - American Family Physician

Feb 15, 2005 - Palpitations-sensations of a rapid or irregular heartbeat-are most often caused by cardiac arrhythmias or anxiety. Most patients with arrhythmias do not complain of palpitations. However, any arrhythmia, including sinus tachycardia, atrial fibrillation, premature ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p743.html

Lymphadenopathy and Malignancy - American Family Physician

Dec 1, 2002 - The majority of patients presenting with peripheral lymphadenopathy have easily identifiable causes that are benign or self-limited. Among primary care patients presenting with lymphadenopathy, the prevalence of malignancy has been estimated to be as low as 1.1 percent. The critical ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1201/p2103.html

Diagnosis of Acute Abdominal Pain in Older Patients - American Family Physician

Nov 1, 2006 - Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1101/p1537.html

Acute Abdominal Pain in Children - American Family Physician

Jun 1, 2003 - Acute abdominal pain in children presents a diagnostic dilemma. Although many cases of acute abdominal pain are benign, some require rapid diagnosis and treatment to minimize morbidity. Numerous disorders can cause abdominal pain. The most common medical cause is gastroenteritis, and ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2321.html

Chronic Cough After Acute Viral Bronchiolitis: Suggestions from the ACCP - Practice ...

May 15, 2019 - To address the high prevalence of bronchiolitis, the effects of chronic cough on patients' quality of life, and adverse effects from inappropriate use of medications, an expert panel from the American College of Chest Physicians performed systematic reviews to develop several ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0515/p654.html

Diagnosing the Cause of Chest Pain - American Family Physician

Nov 15, 2005 - Chest pain presents a diagnostic challenge in outpatient family medicine. Noncardiac causes are common, but it is important not to overlook serious conditions such as an acute coronary syndrome, pulmonary embolism, or pneumonia. In addition to a thorough history and physical ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2012.html

Evaluation of Syncope - American Family Physician

Oct 15, 2005 - Though relatively common, syncope is a complex presenting symptom defined by a transient loss of consciousness, usually accompanied by falling, and with spontaneous recovery. Syncope must be carefully differentiated from other conditions that may cause a loss of consciousness or ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1015/p1492.html

Urinary Incontinence: Screening Recommendation from the WPSI - Practice Guidelines - ...

Feb 1, 2019 - Urinary incontinence adversely affects health, quality of life, and function for most women at some point in their lives. However, it is underreported because of embarrassment, stigma, or acceptance as normal. Early intervention may reduce progression, improve quality of life, and limit...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0201/p194.html

Radiologic Evaluation of Hematuria: Guidelines from the American College of Radiology's...

Aug 1, 2008 - Hematuria, symptomatic and incidental, that involves more than three red blood cells per high-power field on two of three properly collected urinalysis specimens warrants some type of imaging to evaluate the upper tracts. Traditionally, excretory urography or the intravenous pyelogram ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0801/p347.html

Syncope Evaluation and Treatment Guidelines from ACC, AHA, and HRS - Practice ...

Apr 1, 2018 - The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) have released guidelines to assist physicians in evaluating and treating syncope.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0401/p478.html

Evaluation of Patients Presenting with Knee Pain: Part I. History, Physical ...

Sep 1, 2003 - Family physicians frequently encounter patients with knee pain. Accurate diagnosis requires a knowledge of knee anatomy, common pain patterns in knee injuries, and features of frequently encountered causes of knee pain, as well as specific physical examination skills. The history should...

American Family Physician : Article

https://www.aafp.org/afp/2003/0901/p907.html

Diagnostic Approach to Tinnitus - American Family Physician

Jan 1, 2004 - Tinnitus is a common disorder with many possible causes. Most cases of tinnitus are subjective, but occasionally the tinnitus can be heard by an examiner. Otologic problems, especially hearing loss, are the most common causes of subjective tinnitus. Common causes of conductive hearing ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p120.html

Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye" - POEMs - ...

Apr 1, 2018 - For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474.html

Fever in Well-Appearing Children Younger Than Two Years: A Clinical Policy from the ...

Apr 15, 2017 - The American College of Emergency Physicians (ACEP) has released a clinical policy addressing issues in children younger than two years who visit the emergency department with fever, but who appear well.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0415/p524.html

Evaluating Fever of Unidentifiable Source in Young Children - American Family Physician

Jun 15, 2007 - Most children will have been evaluated for a febrile illness by 36 months of age. Although the majority will have a self-limited viral illness, studies done before the use of Haemophilus influenzae type b and Streptococcus pneumoniae vaccines showed that approximately 10 percent of ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0615/p1805.html

Radiologic Evaluation of Acute Chest Pain—Suspected Myocardial Ischemia - American ...

Aug 15, 2007 - The American College of Radiology has developed appropriateness criteria for a number of clinical conditions and procedures. Criteria are available on imaging tests used in the evaluation of acute chest pain--suspected myocardial ischemia. Imaging tests for a suspected cardiac etiology ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p533.html

Evaluating the Febrile Patient with a Rash - American Family Physician

Aug 15, 2000 - The differential diagnosis for febrile patients with a rash is extensive. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion. Rashes can be categorized as maculopapular (centrally and peripherally distributed), petechial, ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0815/p804.html

Gluten Is Not the Culprit in Many Patients’ Symptoms - POEMs - American Family Physician

May 1, 2016 - Gluten may not be the cause of gastrointestinal symptoms in many patients with nonceliac gluten sensitivity. Only one-third of patients on a gluten-free diet experienced symptoms and correctly identified when they were given gluten-containing flour. Almost one-half (49%) of patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p788.html

Anterior Hip Pain - American Family Physician

Oct 15, 1999 - Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1015/p1687.html

Diagnosis of Stridor in Children - American Family Physician

Nov 15, 1999 - Stridor is a sign of upper airway obstruction. In children, laryngomalacia is the most common cause of chronic stridor, while croup is the most common cause of acute stridor. Generally, an inspiratory stridor suggests airway obstruction above the glottis while an expiratory stridor is ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1115/p2289.html

AAO-HNSF Releases Guideline on Managing Tinnitus - Practice Guidelines - American ...

Jul 1, 2015 - Tinnitus, the perception of sound without an external source, can be caused by a variety of conditions. Prevalence in the United States is approximately 10% to 15%. It can be categorized as primary (idiopathic and accompanied by or not by sensorineural hearing loss) and secondary ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0701/p65.html

Evaluation of Chronic Dyspnea - American Family Physician

Apr 15, 2005 - Chronic dyspnea is defined as dyspnea lasting more than one month. In approximately two thirds of patients presenting with dyspnea, the underlying cause is cardiopulmonary disease. Establishing an accurate diagnosis is essential because treatment differs depending on the underlying ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1529.html

Tremor - American Family Physician

Oct 15, 2003 - Tremor, a rhythmic, involuntary, oscillatory movement of body parts, is the most common movement disorder. Tremors are classified as rest or action tremors. Rest tremor occurs when the affected body part is completely supported against gravity. Action tremors are produced by voluntary ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1015/p1545.html

Guidelines for the Diagnosis and Management of Hoarseness - Practice Guidelines - ...

May 15, 2010 - The American Academy of Otolaryngology–Head and Neck Surgery Foundation has released evidence-based guidelines for the evaluation and management of hoarseness. The goals of the guidelines are to improve diagnostic accuracy; reduce inappropriate medication and imaging use; and promote ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/0515/p1292.html

Evaluation of the Patient with Chronic Cough - American Family Physician

May 1, 2004 - Patients with chronic cough should avoid exposure to irritants that can trigger cough, and those who smoke should stop smoking. Patients who develop chronic cough in association with angiotensin-converting enzyme inhibitor therapy should be switched to an agent from another drug class. ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2159.html

A Simple Cough Algorithm for Children with Chronic Cough - POEMs - American Family ...

Nov 15, 2013 - In children with chronic cough, a simple approach of ruling out specific indicators of cause, followed by treating a wet cough with antibiotics, results in a significant decrease in the duration of cough. Some of the causes of chronic cough were reactive airway disease, bronchiectasis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1115/od1.html

Evaluation of Clumsiness in Children - American Family Physician

Oct 15, 2002 - Parents and physicians often dismiss seemingly minor motor difficulties in children. Approximately 6 percent of school-aged children have coordination problems serious enough to interfere with academic performance and social integration. These problems often arise during the early ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1015/p1435.html

Evaluation of Chest Pain in Primary Care Patients - Point-of-Care Guides - American ...

Mar 1, 2011 - Chest pain can be caused by conditions that range from benign and self-limited (e.g., chest wall pain) to serious (e.g., anxiety disorder) or life-threatening (e.g., unstable angina, aortic dissection, pulmonary embolism). Accurate identification of life-threatening and serious causes ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2011/0301/p603.html

Evaluation and Differential Diagnosis of Dyspareunia - American Family Physician

Apr 15, 2001 - Dyspareunia is genital pain associated with sexual intercourse. Although this condition has historically been defined by psychologic theories, the current treatment approach favors an integrated pain model. Identification of the initiating and promulgating factors is essential to ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0415/p1535.html

Reassessing the Role of MRI in the Evaluation of Knee Pain - Editorials - American ...

Feb 1, 2012 - When used for the appropriate indications, MRI is a valuable tool in the evaluation and management of knee pain. However, it may provide clinically irrelevant information by identifying pathology that is not related to a patient's symptoms, which may ultimately lead to unnecessary ...

American Family Physician : Editorials

https://www.aafp.org/afp/2012/0201/p221.html

Evaluating Hoarseness: Keeping Your Patient's Voice Healthy - American Family Physician

Jun 1, 1998 - Hoarseness is the term often used by patients to describe changes in their voice quality. The causes of hoarseness are determined after obtaining a detailed medical history of the circumstances preceding the onset of hoarseness and performing a thorough physical examination. The latter ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0601/p2775.html

A Primary Care Approach to the Patient with Claudication - American Family Physician

Feb 15, 2000 - Peripheral arterial occlusive disease occurs in about 18 percent of persons over 70 years of age. Usually, patients who have this disease present with intermittent claudication with pain in the calf, thigh or buttock that is elicited by exertion and relieved with a few minutes of rest. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1027.html

Evaluation of the Acutely Limping Child - American Family Physician

Feb 15, 2000 - A limp may be defined as any asymmetric deviation from a normal gait pattern. The differential diagnosis of a limp includes trauma, infection, neoplasia and inflammatory, congenital, neuromuscular or developmental disorders. Initially, a broad differential diagnosis should be considered...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1011.html

Hip Pain in Athletes - American Family Physician

Apr 1, 2000 - Hip pain in athletes involves a wide differential diagnosis. Adolescents and young adults are at particular risk for various apophyseal and epiphyseal injuries due to lack of ossification of these cartilaginous growth plates. Older athletes are more likely to present with tendinitis in ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2109.html

An Office Approach to the Diagnosis of Chronic Cough - American Family Physician

Dec 1, 1998 - Chronic cough is a common problem in patients who visit family physicians. The three most common causes of chronic cough in those who are referred to pulmonary specialists are postnasal drip, asthma and gastroesophageal reflux. The initial treatment of patients with cough is often ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1201/p2015.html

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