This revised clinical practice guideline (CPG) addresses the distinct but related lower extremity impairments of those with a first-time lateral ankle sprain (LAS) and those with chronic ankle instability (CAI) Depending on many factors, impairments may continue following injury While most individuals experience resolution of symptoms, complaints of instability may continue and are defined as CAI The aims of the revision were to provide a concise summary of the contemporary evidence since publication of the original guideline and to develop new recommendations or revise previously published recommendations to support evidence-based practice J Orthop Sports Phys Ther 2021;51(4):CPG1-CPG80 doi:102519/jospt20210302

https://www.jospt.org/doi/pdf/10.2519/jospt.2021.0302

Ankle stability and movement coordination impairments: Lateral ankle ligament sprains revision 2021

Background To evaluate the utilization of point-of-care ultrasound (POCUS) for the assessment of emergency department (ED) patients with musculoskeletal symptoms and the impact of musculoskeletal POCUS on medical decision-making and patient management in the ED. Methods This was a retrospective review of ED patients presenting with musculoskeletal symptoms who received a POCUS over a 3.5-year period. An ED POCUS database was reviewed for musculoskeletal POCUS examinations used for medical decision-making. Electronic medical records were then reviewed for demographic characteristics, history, physical examination findings, ED course, additional imaging studies, and impact of musculoskeletal POCUS on patient management in ED. Results A total of 264 subjects (92 females, 172 males) and 292 musculoskeletal POCUS examinations were included in the final analysis. Most common symptomatic sites were knee (31.8%) and ankle (16.3%). Joint effusion was the most common finding on musculoskeletal POCUS, noted in 33.7% of the patients, and subcutaneous edema/cobblestoning was found in 10.2% of the patients. Muscle or tendon rupture was found in 2.3% of the patients, and 1.9% of the patients had joint dislocation. Bursitis or bursa fluid was found in 3.4% of patients, and tendonitis/tendinopathy was found in 2.3%. Twenty percent of them were ultrasound-guided musculoskeletal procedures, and most of them (73.3%) were arthrocentesis. Of the included studies, all except three either changed or helped guide patient management as documented in the patients' medical records. Conclusion Our study findings illustrate the utility of POCUS in the evaluation of a variety of musculoskeletal pathologies in the ED.

/pdf/utility-of-point-of-care-musculoskeletal-ultrasound-in-the-35ub1xuv7n.pdf

Utility of point-of-care musculoskeletal ultrasound in the evaluation of emergency department musculoskeletal pathology.

Traumatic injuries to the extremities are common in athletic competitions. The practitioner providing coverage of sporting events must be prepared to diagnose and provide initial treatment of these injuries. A thorough history and physical examination should result in a provisional diagnosis. Many injuries will require subsequent radiographs or orthopedic consultation. Limb threatening emergencies are rare but must be promptly recognized and referred to a hospital. Early treatment can protect athletes from further injury and may hasten their return to competition. Some athletes with extremity trauma can return to the contest, but this decision must be made on an individual basis.

/pdf/extremity-trauma-field-management-of-sports-injuries-4hfkwyudok.pdf

Extremity trauma: field management of sports injuries

Foot and ankle injuries account for a significant volume of primary care office visits each year. Given the incidence of injury and concern for long-term sequelae, it is imperative that primary care physicians familiarize themselves with commonly encountered foot and ankle injuries. Coupling a sound understanding of key anatomic structures with an appropriately gathered history can help to quickly narrow the differential diagnosis in this clinical presentation. This article focuses on key elements from the history and physical examination as well as provides a concise review of imaging modalities and recommended treatment strategies.

Approaching Foot and Ankle Injuries in the Ambulatory Setting.

Dynamic Techniques for Clinical Assessment of the Athlete

Context:Sidelines coverage presents unique challenges in the evaluation of injured athletes. Health care providers may be confronted with the question of when to obtain radiographs following an inj...

Sideline Coverage: When to Get Radiographs? A Review of Clinical Decision Tools

The purpose of this foot and ankle update is to educate the reader on important foot and ankle topics including current controversies, physical examination, diagnostics, and management. Quick-view lists are used to give easy access to the most significant knowledge points for providing patient care for these entities. These topics were chosen either because they are very common or because of the high morbidity involved should there be a misdiagnosis or mismanagement.

https://www.primarycare.theclinics.com/article/S0095-4543(13)00030-4/pdf

Foot and Ankle Update

Ultrasonography in Musculoskeletal Disorders

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Sideline Coverage: When to Get Radiographs? A Review of Clinical Decision Tools

Foot and Ankle Update

Ultrasonography in Musculoskeletal Disorders