When a patient presents to his or her general practitioner (GP) with a knee injury, the doctor relies on the patient's history (what happened) and a physical exam (clinical tests) to figure out what's wrong. Is there swelling in the joint? Is there damage inside the joint? Can a physician even tell these things with a history and physical exam (H&PE)? When are additional tests such as X-rays or MRIs needed? Researchers from the Netherlands take on these questions in a study of 134 patients with a traumatic knee injury. Most (but not all) injuries were sports-related. Each patient was questioned about their symptoms and then examined by a physical therapist using a standard series of tests for the knee. Tests included range-of-motion, palpation, stability, and meniscal (knee cartilage) tests. Three special tests were done to look for effusion (swelling). The first was palpation of the popliteal fossa (back of the knee). The second was a palpatory test called the minor effusion test ....
BOOM! BOOM! BOOM!
The old soldiers from our local American Legion Honor Guard fired their rifles into the brittle blue sky over my father's grave. It was December in North Dakota, and the cemetery was knee deep in snow. These men were not much younger than the man they helped bury. Earlier, I had marveled at their dedication to a fellow soldier as I watched them march on aging, unsteady feet, through the snow that lead to the burial site.
The flag was removed from Dad's coffin, ceremoniously folded in a tight triangle and handed to my barely comprehending mother, who had stayed in the funeral home's car with the door open. She would have needed a wheelchair to get closer to the grave and she didn't want to move out of the warm car. Part of her seeming lack of comprehension was dementia , part denial and grief.
After we all had climbed back into the funeral cars, one of the funeral home attendants brought to me six shell casings. He apologized for not finding...
Definition Swollen gums are abnormally enlarged, bulging, or protruding. Alternative Names Swollen gums; Gingival swelling Considerations Gum swelling is quite common and may involve one or many of the triangular-shaped bits of gum between nearby teeth. These sections are called papillae. Occasionally, the gums swell significantly, blocking the teeth completely. Common Causes Gingivitis Infection by a virus or fungus Malnutrition Poorly fitting dentures Pregnancy Sensitivity to toothpaste or mouthwash Scurvy Side effect of a drug such as Dilantin or phenobarbital
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