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Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - American Family Physician

Nov 1, 2019 - The allopurinol hypersensitivity assay, or HLA-B*58:01 test, is a blood test to detect the presence of a human leukocyte antigen B (HLA-B) genetic variant that increases the risk of life-threatening, severe cutaneous adverse reactions in patients taking allopurinol.

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p530.html

Screening for Osteoporosis to Prevent Fractures: Recommendation Statement - U.S. ...

Nov 15, 2018 - The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/1115/od1.html

Screening for Osteoporosis to Prevent Fractures - Putting Prevention into Practice - ...

Nov 15, 2018 - A 57-year-old postmenopausal woman comes to your clinic for a wellness visit. She has no significant medical problems. She broke her left forearm as a child by falling out of a tree but has had no other fractures. She currently smokes one pack of cigarettes per day, rarely drinks one ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1115/p593.html

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

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

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

Duration of Bisphosphonate Therapy - FPIN's Help Desk Answers - American Family Physician

Apr 1, 2018 - Oral bisphosphonates significantly reduce clinical fracture risk at four years in women with postmenopausal osteoporosis (T-score less than −2.5). Treatment beyond five years is associated with further reductions in fractures in women with persistent femoral neck T-scores less than −2.5.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od1.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

Treatment of Low BMD and Osteoporosis to Prevent Fractures: Updated Guideline from the ...

Mar 1, 2018 - Osteoporosis, which most commonly occurs in the hip, spine, and wrist, puts persons at increased risk of fragility and fracture. The American College of Physicians (ACP) has updated its 2008 guideline to include new evidence regarding fracture prevention in adults with low bone mineral ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0301/p352.html

Long-Term Use of Bisphosphonates Increases the Risk of Fractures in Older Women - POEMs...

Jan 1, 2018 - In this cohort study, older women at a high risk of fractures who used oral bisphosphonates for 10 to 13 years had a higher risk of fractures than women who used bisphosphonates for only two years.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53a.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

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

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

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

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.html

Antipsychotics for Fibromyalgia in Adults - Medicine by the Numbers - American Family ...

Aug 1, 2017 - Quetiapine may be considered for a limited period (less than 12 weeks) to improve pain, sleep, and depression in fibromyalgia, while considering the potential for weight gain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0801/od1.html

Giant Cell Arteritis: Biopsy After Corticosteroid Initiation - FPIN's Clinical ...

Jan 15, 2017 - Corticosteroid therapy in patients with suspected giant cell arteritis should not degrade the accuracy of temporal artery biopsy if the biopsy is performed within four weeks of corticosteroid initiation. Temporal artery biopsy can be performed up to four weeks after starting high-dose ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0115/p116.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

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

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

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 Vertebral Compression Fractures - American Family Physician

Jul 1, 2016 - Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p44.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

Risk of Gout with the Use of Thiazide Diuretics - FPIN's Clinical Inquiries - American ...

Oct 1, 2015 - Thiazide diuretics may be used in most patients with hypertension who have only minimally increased risk of gout.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/1001/p622.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.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

Common Questions About the Diagnosis and Management of Fibromyalgia - American Family ...

Apr 1, 2015 - Fibromyalgia has a distinct pathophysiology involving central amplification of peripheral sensory signals. Core symptoms are chronic widespread pain, fatigue, and sleep disturbance. Most patients with fibromyalgia have muscle pain and tenderness, forgetfulness or problems concentrating,...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p472.html

Controlled-Release Oxycodone for Neuropathic Pain and Fibromyalgia in Adults - Cochrane...

Mar 1, 2015 - Oxycodone CR has limited effectiveness for the treatment of diabetic neuropathy or postherpetic neuralgia. Evidence is lacking regarding treatment benefit for other neuropathic pain syndromes or fibromyalgia. Adverse effects of oxycodone CR therapy are common.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0301/p286.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

Diagnosis, Treatment, and Prevention of Gout - American Family Physician

Dec 15, 2014 - Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalangeal joint, resulting from precipitation of monosodium urate crystals in a joint space. Gout is typically diagnosed using clinical criteria from the American College of Rheumatology. Diagnosis...

American Family Physician : Article

https://www.aafp.org/afp/2014/1215/p831.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

Hip Fracture: Diagnosis, Treatment, and Secondary Prevention - American Family Physician

Jun 15, 2014 - Hip fractures cause significant morbidity and are associated with increased mortality. Women experience 80% of hip fractures, and the average age of persons who have a hip fracture is 80 years. Most hip fractures are associated with a fall, although other risk factors include decreased ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p945.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

Vitamin D and Calcium Supplementation to Prevent Fractures in Adults - Putting ...

Jun 1, 2014 - A 55-year-old woman presents to your office for a refill of her blood pressure medication. She is otherwise healthy and does not take other medications. She states that her older sister has been taking vitamin D and calcium supplements for several years to keep her bones strong, and ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/0601/p897.html

Vitamin D and Calcium Supplementation to Prevent Fractures in Adults - U.S. Preventive ...

Jun 1, 2014 - Advertisement << Previous article Next article >> Jun 1, 2014 Issue U.S. Preventive Services Task Force Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: Recommendation Statement Am Fam Physician. 2014 Jun 1;89(11):online. Related Putting Prevention into...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2014/0601/od1.html

Repeat BMD Testing: Little, If Any, Value in Older Men and Women - POEMs - American ...

Dec 15, 2013 - This study found little, if any, additional benefit to repeat BMD screening at four years beyond baseline BMD testing in older men and women. A recent similar study (Gourlay ML, Fine JP, Preisser JS, et al. N Engl J Med. 2012;366(3):225–233) recommended a baseline examination at 65 ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/p864.html

Recognition and Management of Polymyalgia Rheumatica and Giant Cell Arteritis - ...

Nov 15, 2013 - Polymyalgia rheumatica affects proximal muscles and joints, causing disability in older adults. Giant cell arteritis affects medium and large arteries and can result in blindness. These conditions overlap significantly, often occurring together. Despite the similarities, each has ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1115/p676.html

Risks of Bisphosphonate Use - FPIN's Clinical Inquiries - American Family Physician

Nov 15, 2013 - Bisphosphonates are associated with a small risk of atypical femoral shaft fractures, which increases with duration of use. Bisphosphonates are associated with a small risk of osteonecrosis of the jaw, which is more common in patients who are older, female, or have poor dental hygiene ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1115/p697.html

ACR Publishes Guidelines for Pharmacologic and Nonpharmacologic Treatment of Gout - ...

Sep 15, 2013 - The American College of Rheumatology (ACR) has developed recommendations for the management of gout. The recommendations call for a systematic nonpharmacologic and pharmacologic management approach that is intended to be applicable to all patients with gout.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0915/p408.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

Denosumab (Prolia) for Treatment of Postmenopausal Osteoporosis - STEPS - American ...

Feb 15, 2012 - Prolia is an expensive method of preventing osteoporotic hip fractures, and is associated with significant adverse effects. Safer, less expensive options exist for preventing fracture in high-risk women.

American Family Physician : STEPS

https://www.aafp.org/afp/2012/0215/p334.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

Febuxostat (Uloric) for Hyperuricemia and Gout - STEPS - American Family Physician

May 15, 2010 - Febuxostat more effectively lowers serum uric acid to goal levels than does allopurinol; however, this benefit is offset by a slightly higher incidence of adverse effects and treatment discontinuation. Until superiority for patient-oriented outcomes is shown in comparative trials with ...

American Family Physician : STEPS

https://www.aafp.org/afp/2010/0515/p1287.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

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

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

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