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A Family Physicians' Guide to Monitoring Methotrexate - American Family Physician

Oct 1, 2000 - Methotrexate has a long history of use in the treatment of various immunologic diseases, including rheumatoid arthritis and psoriasis. Although the drug is usually prescribed by a subspecialist, a family physician may assume responsibility for monitoring methotrexate therapy. Major ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1001/p1607.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

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

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

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

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

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

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

AGA Reviews the Use of Corticosteroids Immunomodulators, and Infliximab in IBD - ...

Feb 1, 2007 - The American Gastroenterological Association Institute (AGA) has issued a clinical position statement on corticosteroids, immunomodulators, and infliximab (Remicade) use in managing inflammatory bowel disease (IBD).

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2007/0201/p410.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

Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - Diagnostic Tests: What ...

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 : Diagnostic Tests: What Physicians Need to Know

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

ANCA-Associated Small-Vessel Vasculitis - American Family Physician

Apr 15, 2002 - Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is the most common primary systemic small-vessel vasculitis to occur in adults. Although the etiology is not always known, the incidence of vasculitis is increasing, and the diagnosis and management of patients may be ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0415/p1615.html

Antibody Testing for Systemic Lupus Erythematosus - FPIN's Clinical Inquiries - ...

Dec 15, 2011 - Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/1215/p1407.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

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

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

Chronic Musculoskeletal Pain in Children: Part II. Rheumatic Causes - American Family ...

Jul 15, 2006 - Primary care physicians should have a working knowledge of rheumatic diseases of childhood that manifest primarily as musculoskeletal pain. Children with juvenile rheumatoid arthritis can present with painless joint inflammation and may have normal results on rheumatologic tests. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p293.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

Clinical Utility of Common Serum Rheumatologic Tests - American Family Physician

Mar 15, 2002 - Serum rheumatologic tests are generally most useful for confirming a clinically suspected diagnosis. Testing for rheumatoid factor is appropriate when rheumatoid arthritis, Sjögren's syndrome or cryoglobulinemia is suspected. Antinuclear antibody testing is highly sensitive for ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0315/p1073.html

Clinical Utility of the Erythrocyte Sedimentation Rate - American Family Physician

Oct 1, 1999 - The erythrocyte sedimentation rate (ESR) determination is a commonly performed laboratory test with a time-honored role. However, the usefulness of this test has decreased as new methods of evaluating disease have been developed. The test remains helpful in the specific diagnosis of a ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1001/p1443.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

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

Corticosteroid Injections for Common Musculoskeletal Conditions - American Family ...

Oct 15, 2015 - Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p694.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

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

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

Diagnosis and Management of Gout - American Family Physician

Apr 1, 1999 - Gout is a disease resulting from the deposition of urate crystals caused by the overproduction or underexcretion of uric acid. The disease is often, but not always, associated with elevated serum uric acid levels. Clinical manifestations include acute and chronic arthritis, tophi, ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0401/p1799.html

Diagnosis and Management of Rheumatoid Arthritis - American Family Physician

Dec 1, 2011 - Rheumatoid arthritis is the most commonly diagnosed systemic inflammatory arthritis. Women, smokers, and those with a family history of the disease are most often affected. Criteria for diagnosis include having at least one joint with definite swelling that is not explained by another ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1245.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

Diagnosis and Management of Sjogren Syndrome - American Family Physician

Mar 15, 2009 - Sjogren syndrome is a systemic autoimmune disease characterized by dry eyes and dry mouth. Other organ systems are affected in many patients. Sjogren syndrome is classified as primary or secondary. In primary disease, Sjogren syndrome is a solitary process, whereas secondary disease ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0315/p465.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

Diagnosis of Systemic Lupus Erythematossus - American Family Physician

Dec 1, 2003 - Systemic lupus erythematosus is a multisystem inflammatory disease that is often difficult to diagnose. Before the diagnosis can be established, four of 11 clinical and laboratory criteria must be met. Antinuclear antibody titer is the primary laboratory test used to diagnose systemic ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1201/p2179.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

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

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

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

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

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

Evaluation of Poststreptococcal Illness - American Family Physician

May 15, 2005 - Group A beta-hemolytic streptococcal pharyngitis, scarlet fever, and rarely asymptomatic carrier states are associated with a number of poststreptococcal suppurative and nonsuppurative complications. As in streptococcal pharyngitis, acute rheumatic fever, pediatric autoimmune ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0515/p1949.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

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

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

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

Gout and Hyperuricemia - American Family Physician

Feb 15, 1999 - Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p925.html

Gout: An Update - American Family Physician

Sep 15, 2007 - Arthritis caused by gout (i.e., gouty arthritis) accounts for millions of outpatient visits annually, and the prevalence is increasing. Gout is caused by monosodium urate crystal deposition in tissues leading to arthritis, soft tissue masses (i.e., tophi), nephrolithiasis, and urate ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0915/p801.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

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