American family physician
-
Hip and knee injections are useful diagnostic and therapeutic tools for family physicians. This article reviews anatomic landmark-guided and ultrasound-guided injections and aspiration techniques for greater trochanteric pain syndrome, the hip joint, the knee joint, the pes anserine bursa, and the iliotibial band. Indications for injections include acute and chronic inflammatory conditions, such as rheumatoid arthritis; osteoarthritis; overuse; and traumas. ⋯ The most common complications are local inflammatory reactions to the injectant. These reactions usually cause soreness for 24 to 48 hours, then spontaneously resolve. Follow-up after injections is usually scheduled within two to six weeks.
-
American family physician · Oct 2023
Female Family Physicians May Earn $1.8 Million Less Than Male Peers Over a Lifetime.
The average salaries of female physicians are lower than those of their male peers. Previous studies demonstrate that female family physicians earn approximately 16% less than their male counterparts.1 However, multiple studies have demonstrated benefits of having a female physician, including quality of care and relationships.2,3 After controlling for multiple variables, the wage gap persists, making gender biases the most likely explanation.
-
Cryptorchidism refers to an undescended testicle, the most common genitourinary malformation in male children. It is diagnosed with history and physical examination findings, and primary care physicians play a key role in the early identification of the condition. Early surgical intervention reduces the risk of testicular cancer and preserves fertility. ⋯ Patients with bilateral undescended testicles that are nonpalpable should undergo endocrinologic evaluation for sexual development disorders. Retractile testicles are a variant of cryptorchidism and should be monitored annually until puberty, when acquired ascent becomes unlikely due to greater testicular volume. Based on expert opinion, all patients with a history of cryptorchidism should undergo annual clinical examination and be taught self-examination techniques for early detection of testicular cancer.
-
High-quality research on the safety and effectiveness of over-the-counter medications in pregnancy is limited. Physicians should explore nonpharmacologic treatments before recommending medication. For nausea and vomiting in pregnancy, vitamin B6 (pyridoxine), H1 antihistamines, and ginger are safe and effective. ⋯ The safety of acetaminophen for the treatment of headaches and low back pain during pregnancy has come into question with recent studies; therefore, judicious use is advised. Physicians should screen all pregnant patients for their risk of developing preeclampsia and initiate low-dose aspirin from 12 weeks' gestation until delivery for those at increased risk. Data are limited on the safety and effectiveness of herbal supplements during pregnancy.