scholarly journals Radiographic change is common in new presenters in primary care with hip pain

Rheumatology ◽  
2000 ◽  
Vol 39 (7) ◽  
pp. 772-775 ◽  
Author(s):  
F. Birrell ◽  
P. Croft ◽  
C. Cooper ◽  
G. Hosie ◽  
G. J. Macfarlane ◽  
...  
Keyword(s):  
Primary Care ◽  
Hip Pain ◽  
Radiographic Change

scholarly journals Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: A prospective observational study in a primary care setting in Japan

2019 ◽  
Author(s):  
Takashi Akimoto ◽  
Tadashi Kobayashi ◽  
Hiroki Maita ◽  
Hiroshi Osawa ◽  
Hiroyuki Kato
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Fluid Retention ◽  
Hip Pain ◽  
Joint Fluid ◽  
Initial Assessment ◽  
Hip Arthritis ◽  
Imaging Results

Abstract Background Acute hip pain caused by femoral proximal fractures or acute hip arthritis requires imaging for accurate diagnosis. Although pocket-sized ultrasound (PsUS) offers several advantages over other imaging modalities, there is limited information regarding its use in diagnosing femoral proximal fractures or acute hip arthritis. Thus, we aimed to validate the diagnostic accuracy of PsUS for both disorders. Methods In this prospective observational study, outpatients with acute hip pain were diagnosed according to a fixed procedure of the PsUS probe handling. We verified the diagnostic accuracy of PsUS findings (cortical discontinuity and joint fluid retention) and compared it with that of radiography, computed tomography, and magnetic resonance imaging. Results Our study included 52 outpatients (mean age, 78.0 years; female, 88.5%). Of 26 patients diagnosed with femoral proximal fractures, 14 had femoral neck fractures and 12 had femoral trochanteric fractures. Six patients had arthritis. The sensitivity and specificity for identifying cortical discontinuity in femoral proximal fractures were 0.96 and 0.92, respectively, and those for identifying joint fluid retention in acute hip arthritis were 1.00 and 0.65, respectively. The sensitivity for identifying either cortical discontinuity or joint fluid retention in femoral proximal fractures or acute hip arthritis was 0.97. Conclusions Negative PsUS findings of cortical discontinuity and joint fluid retention in the hip are useful for ruling out femoral proximal fractures and acute hip arthritis. PsUS and radiography have comparable diagnostic accuracies, and PsUS could aid in the initial assessment of acute hip pain among the elderly in primary care settings.

scholarly journals Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: A prospective observational study in a primary care setting in Japan

2020 ◽  
Author(s):  
Takashi Akimoto ◽  
Tadashi Kobayashi ◽  
Hiroki Maita ◽  
Hiroshi Osawa ◽  
Hiroyuki Kato
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Diagnostic Accuracy ◽  
Prospective Observational Study ◽  
Fluid Retention ◽  
Hip Pain ◽  
Joint Fluid ◽  
Initial Assessment ◽  
Hip Arthritis ◽  
Imaging Results

Abstract Background Acute hip pain caused by femoral proximal fractures or acute hip arthritis requires imaging for accurate diagnosis. Although pocket-sized ultrasound (PsUS) offers several advantages over other imaging modalities, there is limited information regarding its use in diagnosing femoral proximal fractures or acute hip arthritis. Thus, we aimed to validate the diagnostic accuracy of PsUS for both disorders. Methods In this prospective observational study, outpatients with acute hip pain were diagnosed according to a fixed procedure of the PsUS probe handling. We verified the diagnostic accuracy of PsUS findings (cortical discontinuity and joint fluid retention) and compared it with that of radiography, computed tomography, and magnetic resonance imaging. Results Our study included 52 outpatients (mean age, 78.0 years; female, 88.5%). Of 26 patients diagnosed with femoral proximal fractures, 14 had femoral neck fractures and 12 had femoral trochanteric fractures. The sensitivity and specificity for identifying cortical discontinuity in femoral proximal fractures were 0.96 and 0.92, respectively. The sensitivity for identifying either cortical discontinuity or joint fluid retention in femoral proximal fractures or acute hip arthritis was 0.97. Conclusions Negative PsUS findings of cortical discontinuity and joint fluid retention in the hip are useful for ruling out femoral proximal fractures and acute hip arthritis. PsUS and radiography have comparable diagnostic accuracies, and PsUS could aid in the initial assessment of acute hip pain among the elderly in primary care settings.

Femoroacetabular impingement: presence of FAI-like features on conventional radiography in young patients presenting to primary care with hip pain

2013 ◽  
Vol 54 (6) ◽  
pp. 690-697 ◽  
Author(s):  
Carl Sullivan ◽  
Julian Chakraverty ◽  
Kieran Foley ◽  
Srikanth Narayanaswamy ◽  
Sridhar Kamath
Keyword(s):  
Primary Care ◽  
Femoroacetabular Impingement ◽  
Young Patients ◽  
Conventional Radiography ◽  
Hip Pain

THU0647-HPR Improving Access To A Better Model of Care for People with Knee and Hip Pain in Primary Care - The Osteoarthritis Advisor

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1273.1-1273
Author(s):  
M. Hurley ◽  
A. Walker ◽  
F. Sibley ◽  
A. Carter ◽  
D. Stamp ◽  
...  
Keyword(s):  
Primary Care ◽  
Hip Pain ◽  
Model Of Care

scholarly journals A cycling and education intervention for the treatment of hip osteoarthritis: A quality improvement replication programme

2020 ◽  
Vol 8 ◽  
pp. 205031212094652
Author(s):  
Thomas W Wainwright ◽  
Louise C Burgess ◽  
Tikki Immins ◽  
Neil Cowan ◽  
Robert G Middleton
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Secondary Care ◽  
Weight Bearing ◽  
Hip Osteoarthritis ◽  
Hip Pain ◽  
Education Intervention ◽  
Timed Up And Go ◽  
Original Cohort ◽  
Patient Reported

Objectives: The Cycling against Hip Pain programme is a 6-week exercise and education treatment pathway for people with hip osteoarthritis. Preliminary results of the Cycling against Hip Pain programme found significant improvements in clinical and patient-reported outcome measures for patients referred from primary care. This article evaluates the effectiveness of the changes made to the pathway in a quality improvement replication programme. Methods: The replicated Cycling against Hip Pain programme was delivered between February 2018 and September 2019 in a region of England with a high percentage of adults aged over 65 years. All participants were referred from the orthopaedic outpatient department of the funding hospital (secondary care). The programme was delivered at a local leisure centre and combined 30 min of education on osteoarthritis with 30 min of progressive static cycling, once a week for 6 weeks. Results: The participants on the replicated Cycling against Hip Pain programme did not differ from the original cohort in terms of age or pre-programme weight, however, presented with worse hip symptoms at baseline. Consistent with the findings from the original cohort, participants demonstrated significant improvements to their Oxford Hip Score, 30-s chair stand performance, Timed Up and Go score, Hip Osteoarthritis Outcome Score function and pain, EQ5D health rating, EQ5D-5L score and pain at rest and on weight bearing. In addition, participants reported an increase in knowledge, confidence and motivation to exercise. Conclusion: A 6-week cycling and education intervention for the treatment of hip osteoarthritis provided benefits to function, pain and quality of life for patients referred from secondary care. These results are consistent with findings from patients who were referred from primary care and further support the potential of the pathway in the conservative management of hip osteoarthritis.

scholarly journals β-blocker prescription is associated with lower cumulative risk of knee osteoarthritis and knee pain consultations in primary care: a propensity score matched cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Georgina Nakafero ◽  
Matthew J Grainge ◽  
Ana M Valdes ◽  
Nick Townsend ◽  
Christian Mallen ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Propensity Score ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Cumulative Risk ◽  
Hip Pain ◽  
Knee Oa ◽  
Β Blocker ◽  
Β Blockers

Abstract Objectives To examine the association between β-blocker prescription and first primary-care consultation for knee osteoarthritis (OA), hip OA, knee pain and hip pain. Methods Data source: Clinical Practice Research Datalink. Participants aged ≥40 years in receipt of new oral β-blocker prescriptions were propensity score (PS) matched to an unexposed control. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CI) were calculated, and adjusted for non-osteoporotic fractures, number of primary-care consultations for knee or hip injury, and, the number of primary-care consultations, out-patient referrals and hospitalizations in the 12-months preceding cohort entry. Analysis was stratified according to β-blocker class and for commonly prescribed drugs. p< 0.05 was statistically significant.   Results 111 718 β-blocker exposed participants were 1:1 PS matched to unexposed controls. β-blocker prescription was associated with reduced cumulative risk of knee OA, knee pain, and hip pain consultations with aHR(95%CI) 0.90(0.83–0.98); 0.88(0.83–0.92), and 0.85(0.79–0.90), respectively. Propranolol and atenolol were associated with a lower incidence of knee OA and knee pain consultations with aHRs between 0.78–0.91. β-blockers were associated with reduced incidence of consultation for large-joint lower-limb OA/pain as a composite outcome, defined as earliest of knee OA, knee pain, hip OA or hip pain consultation (aHR(95%CI) 0.87(0.84–0.90)). Conclusion Commonly used β-blockers have analgesic properties for musculoskeletal pain. Atenolol might be a therapeutic option for OA and cardiovascular co-morbidities in which β-blockers are indicated, while propranolol may be suitable for people with co-morbid anxiety. A confirmatory randomised controlled trial is needed before clinical practice is changed.

scholarly journals Adult hip pain

2019 ◽  
Vol 13 (1) ◽  
pp. 21-27
Author(s):  
Aman Jain ◽  
Katie Clamp
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Secondary Care ◽  
Management Strategies ◽  
Hip Pain ◽  
Good Knowledge ◽  
Musculoskeletal Conditions ◽  
Urgent Referral ◽  
Common Causes ◽  
Anatomy Of The Hip

Hip pain is one of the most common musculoskeletal presentations in general practice. There are multiples causes of hip pain, ranging from acute to chronic and traumatic to atraumatic. In general practice, it is important to identify the cause of hip pain, as management strategies vary depending on pathology. Some diagnoses need urgent referral to secondary care, whereas others can be managed in primary care. According to the RCGP, an estimated 1-in-5 consultations are for musculoskeletal conditions, so a good knowledge of management is important. In this article, we will discuss the anatomy of the hip, the most common causes of hip pain and their management.

Improving access to better care for people with knee and/or hip pain: service evaluation of allied health professional-led primary care

2017 ◽  
Vol 16 (1) ◽  
pp. 222-232 ◽  
Author(s):  
A. Walker ◽  
R. Williams ◽  
F. Sibley ◽  
D. Stamp ◽  
A. Carter ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Professional ◽  
Allied Health ◽  
Service Evaluation ◽  
Hip Pain ◽  
Allied Health Professional

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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