Addressing Immunization Health Disparities
Vaccines can prevent illness but are effective only if they reach a majority of the population at risk. Disparities based on many factors, such as race and ethnicity, economic status, and rural versus urban locations of residents, are ongoing issues in the United States. Reasons for disparities include cost, access, coverage, attitudes/beliefs, and systems issues. At the government level, programs like Vaccines for Children, Medicaid reform, Medicare, and state efforts funded in part by 317 grants have helped reduce but not eliminate disparities. At a practice level, vaccine disparities can be addressed by community outrea...
Source: Primary Care: Clinics in Office Practice - July 7, 2020 Category: Primary Care Authors: Melissa L. Martinez, Sarah Coles Source Type: research

Improving Immunization Coverage in Special Populations
This highlights the key recommendations for immunization in the setting of chronic disease, children and adults with special needs, and health care providers. Immunization is an effective strategy to reduce the burden of suffering and cost of care from chronic disease. Standard child and adolescent and adult immunization schedules identify categories of high-risk conditions and chronic diseases. Clinicians need to develop systems to evaluate patients ’ risk factors and tailor immunization recommendations to their individual needs. Patients with intellectual disabilities, neurologic and neurodevelopmental disorders, a...
Source: Primary Care: Clinics in Office Practice - July 4, 2020 Category: Primary Care Authors: Mary M. Stephens, Erin Kavanaugh Source Type: research

Recognizing Vaccine-Preventable Diseases and Managing Outbreaks
This article describes the populations most at risk from illnesses associated with sporadic outbreaks, with information on diagnosis, treatment, and ways to limit the spread of infection. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 4, 2020 Category: Primary Care Authors: Jennifer L. Hamilton Source Type: research

What ’s New in Vaccine Science
Today vaccines can provide immunity against and treatment of a growing number of diseases including noninfectious conditions. Vaccine science continues to evolve newer and safer ways to deliver prevention and treatment of infectious and noninfectious diseases. This includes new adjuvants to enhance immunogenicity; delivery systems to reduce pain and improve acceptability; a wider range of uses including preventing emerging infectious diseases, such as Zika virus and Ebola, treatment of chronic diseases, such as cancer, and autoimmune disorders; and repurposing of existing vaccines, such as bacillus Calmette-Gu érin ...
Source: Primary Care: Clinics in Office Practice - July 4, 2020 Category: Primary Care Authors: Margot Savoy Source Type: research

Establishing and Maintaining a Vaccine-Positive Practice Culture
A vaccine-positive practice culture encourages immunization against vaccine-preventable diseases by supporting policies and practices that reduce barriers and improve efficacy for vaccine delivery. Key components of a vaccine-positive practice include a well-trained, knowledgeable, collaborative health care practice team; access to immunizations in the practice; and a vaccine practice champion. Leveraging these encourages a provaccine environment and fosters productive dialogue, even among vaccine-hesitant patients/parents. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 4, 2020 Category: Primary Care Authors: Amra A. Resic Source Type: research

Vaccine Policy in the United States
This article discusses the federal agencies involved in vaccine development and recommendation, other organizations involved in vaccine policy, and the role of vaccine-related public health law in promoting universal vaccination. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 4, 2020 Category: Primary Care Authors: John W. Epling Source Type: research

Impact of Human Papillomavirus Vaccination in Reducing Cancer
Human papillomavirus (HPV) is a significant cause of global morbidity and mortality. A nonavalent HPV vaccine is widely available and recommended for routine use at 11 to 12  years old. Older teens and adults though age 45 years also could be offered vaccination. Widespread use of the HPV vaccine appears to impact the rate of infections and cancers. Some parents/teens may hesitate to be vaccinated. The strongest predictor to receiving the vaccine remains a trusted hea lth care professional making a strong recommendation to receive the vaccine. New HPV vaccines are in the pipeline, including therapeutic vaccines t...
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Mina S. Khan, Margot Savoy Source Type: research

The Immunization Conundrum
It is an intriguing time to be a vaccine science expert. At our fingertips is a wealth of safe, effective vaccines to prevent disease. We have expanding knowledge of how to identify those in greatest need and tailor the schedules to maximize their benefit in special populations. We leverage growing understanding of maternal immunity to boost immunity in our vulnerable infants, protecting them from deadly infectious diseases. We have access to rapidly advancing technology poised to transform immunization from a mechanism primarily to prevent infectious contagious disease to one that could treat and prevent chronic diseases....
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Margot Savoy Tags: Preface Source Type: research

Vaccinating in Pregnancy: Opportunities and Challenges
The continuum of preconception, antenatal period, fourth trimester, and interconception period are a critical time for comprehensive care to advance maternal-child health and deliver family-centered care. Immunizations are a key component of this care delivery; however, there are intricacies around indications of vaccinations during this key period. Both active immunity to the individual receiving the vaccine as well as passive immunity passed to the fetus during pregnancy highlight the benefits of this care. Understanding the indications and benefits of vaccine administration during this continuum is critical for provider...
Source: Primary Care: Clinics in Office Practice - July 2, 2020 Category: Primary Care Authors: Alexandra Schieber, David O ’Gurek Source Type: research

Creating a Sustainable Vaccine Delivery Practice
Providing vaccines places a significant logistical and financial burden on an office but is important in providing care to patients. Start the process by finding a vaccine champion, choosing a primary and backup vaccine coordinator, and creating a team in the office to promote and administer vaccines. Follow best practices when storing and monitoring vaccines. Create office policies for ordering vaccines in a fiscally sound manner, accepting deliveries, and managing inventory. Have backup processes in place to avoid preventable errors when administering vaccines. In addition, bill vaccine administration codes appropriately...
Source: Primary Care: Clinics in Office Practice - July 2, 2020 Category: Primary Care Authors: Jamie Loehr Source Type: research

Communicating About Immunizations
A significant minority of patients and parents are vaccine hesitant, defined as having the desire to delay or defer immunizations despite easy access to vaccines. Vaccine hesitancy exists along a spectrum, from patients who are concerned but willing to accept the recommended vaccine schedule to those who wish to use a delayed schedule to those who refuse vaccines altogether. A strong recommendation in favor of a vaccine is the most important reason a patient or parent accepts the immunization. Structural changes, such as removing personal and religious exemptions for vaccines required for attending school, are effective to...
Source: Primary Care: Clinics in Office Practice - July 2, 2020 Category: Primary Care Authors: Jamie Loehr Source Type: research

The World Has Changed
I am very privileged to have been the consulting editor of Primary Care: Clinics in Office Practice since 2007 and am honored to continue serving our readers. Like my colleague consulting editors across the many other Clinics series, we strive to provide key topics for each issue coupled with relevant subtopics authored by leading experts. This issue on immunizations is no different. Yet since our plan to create this important issue, the world has changed. Forever. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 24, 2020 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Vaccine Safety
The details of vaccine development, licensing, and monitoring have never been more important and relevant to the health care conversation in the United States. The potential exists for a preventive medicine such as a vaccine to cause harm, and physicians and patients need to understand the real balance of risks and benefits of immunization. Vaccines given in the United States undergo rigorous testing before licensure as well as extensive postlicensure safety monitoring. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 20, 2020 Category: Primary Care Authors: Laura Morris, Sarah Swofford Source Type: research

Disorders of Pubertal Onset
Evaluation of the child with abnormal pubertal development can be challenging for the primary care provider. Understanding the factors associated with timing of pubertal onset and the normal sequence of pubertal changes is useful in evaluation of children with puberty disorders. A thorough workup includes assessment of growth rate, Tanner staging, and rate of pubertal progression, in addition to an extensive history and physical examination to identify signs and symptoms of disorders associated with abnormal pubertal timing. Initial diagnostic studies will most often include a bone age, levels of gonadotropins, and levels ...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Swati V. Elchuri, Jennifer J. Momen Source Type: research

Adolescent Vaccines
This article reviews the current guidelines, recommended vaccinations and schedules, and methods to improve compliance rates. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Megan Adelman, Ashleigh L. Barrickman, Gretchen K. Garofoli Source Type: research

School-Based Health Care
This article illustrates the various models of school-based health care, the particular benefit of school-based health care for adolescents, and opportunities and challenges in maintaining and sustaining a school-based health program. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Steve North, Danielle G. Dooley Source Type: research

Evaluation and Treatment of Primary Headaches in Adolescents
Headache is a common episodic and chronic pain syndrome in adolescents. Evaluation of headaches in primary care requires a comprehensive assessment including lifestyle behaviors and physical examination, as well as an understanding of when to pursue appropriate testing. Primary headache disorders seen in adolescents include migraine and tension-type headache. Pharmacologic management for primary headache includes both acute and prophylactic treatment strategies. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Suzy Mascaro Walter, Christine Banvard-Fox, Courtney Cundiff Source Type: research

Selected Musculoskeletal Issues in Adolescents
Musculoskeletal care of the adolescent patient involves unique knowledge of their rapidly changing physical and psychological health. In this article, the importance of preventing early sports specialization is elucidated, and an encouragement of the safety and necessity of resistance training in adolescents is undertaken. It also explores two common conditions, one affecting the immature skeleton (apophysitis), and one affecting the improperly developed muscular system (patellofemoral syndrome), both of which are diagnosed clinically, and require little advanced imaging. Finally, a brief overview of relative energy defici...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Kevin Bernstein, Paul Seales, Alex Mroszczyk-McDonald Source Type: research

Providing Care for Transgender and Gender Diverse Youth
This article educates providers about TGDY, reviews the role of mental health care, and provides an overview of medical interventions for gender affirmation. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Kacie M. Kidd, Caitlin Thornburgh, Catherine F. Casey, Pamela J. Murray Source Type: research

Health Care for Refugee and Immigrant Adolescents
This article describes the current scope of immigration to the United States, defines the different categories of immigrants, and describes the Centers for Disease Control and Prevention –mandated overseas and postarrival medical assessment of adolescent refugees. Guidelines for primary care physicians who care for refugee youth are provided, including diagnosis and treatment of common medical and mental health conditions. Special considerations in caring for this vulnerable popul ation include acknowledging prior traumas, acculturation and challenges to education such as bullying, and adjustment to a new health care...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Carina M. Brown, Lalitha Swaminathan, Nadia T. Saif, Fern R. Hauck Source Type: research

Human Trafficking in Adolescents
This article describes core design features of a youth-centered approach to care that 2 organizations —Mount Sinai Adolescent Health Center and Covenant House New Jersey—use to serve clients in nontraditional primary care settings and subsequently illustrates the ways in which this approach succeeds at identifying and serving youth who have experienced human trafficking. Primary care providers a re uniquely positioned to connect adolescent human trafficking survivors to existing protection and treatment resources. The primary care community can adapt these interventions for adolescent patients who have experien...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Julia Einbond, Angela Diaz, Anastasia Cossette, Rosalyn Scriven, Silvia Blaustein, Martha R. Arden Source Type: research

Crisis and Adolescents
This article highlights the impact of crisis and trauma on adolescents. An overview of current assessments and evidence-based interventions to address adolescent patients ’ crisis needs is provided. In addition, recommendations for community referrals and partnerships that could improve the health outcomes of these youth are discussed. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Patrice M. Leverett, Stephanie D ’Costa, Heather Cassella, Manan Shah Source Type: research

Sexual Assault in Adolescents
Child sexual abuse is a severely underreported crime in the United States. The consequences of child sexual abuse extend beyond physical injury, including an increased likelihood to develop chronic physical and mental diseases/disorders, including substance abuse and suicide. Care involves trauma-informed screening, assessment, and documentation, education of, and access to sexually transmitted infection prophylaxis and emergency contraception, safety interventions, and access to community resources. Medical providers should know the response process their facility, community, and state practices for victims of sexual abus...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Christine Banvard-Fox, Meredith Linger, Debra J. Paulson, Lesley Cottrell, Danielle M. Davidov Source Type: research

Human Immunodeficiency Virus in Adolescents
Adolescents and young adults are at high risk for human immunodeficiency virus (HIV) infection. Several risk factors that strongly contribute to HIV infection risk are described, including physical, cognitive, social, and economic factors. Strategies for screening and prevention of HIV infection, including universal screening, behavioral counseling, and preexposure prophylaxis, are reviewed, and the initial treatment approach to a diagnosis of HIV in adolescents is outlined. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Jennifer J. Chang, Amie M. Ashcraft Source Type: research

Adolescent Sexual Health
This article discusses the appropriate language to use while conducting a sexual history, summarizes the epidemiologic data on sexually transmitted infections, and reviews the screening and reporting guidelines set forth by the United States Preventive Services Task Force and the Centers for Disease Control and Prevention. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Roanna Kessler, B. Tate Hinkle, Amy Moyers, Benjamin Silverberg Source Type: research

Adolescent Substance Abuse
Adolescent substance abuse is America ’s #1 public health problem as per the National Center on Addiction and Substance Abuse. People are most likely to begin abusing drugs during adolescence, and the longer adolescents defer experimentation, the less likely they are to develop long-term drug abuse problems. The CRAFFT and DAST questi onnaires are brief, reliable tools for adolescent substance abuse screening. Health care professionals can help continue low adolescent substance utilization rate by having open conversations with adolescents regarding all substances and medications, including illicit substances. (Sourc...
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Mark Garofoli Source Type: research

Culture Shock and Changing Times
I remember the culture shock of entering high school in 1984 like it was yesterday. Being an only child, and not having much exposure to children older than I was, I didn ’t have much of a reference point for what “becoming a teenager” really meant. Transitioning from a small private school in Connecticut to a larger public school in upstate New York opened my eyes very quickly. The first week of school I saw a classmate get his locker searched: The school offi cials found marijuana, and that’s pretty much the last we ever saw of that guy. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Too Much Go, Not Enough Slow: Navigating the Challenges of Adolescence
According to the German-American psychologist Erik Erikson,1 individuals are wrestling with their sense of identity during adolescence. This includes both vocation (purpose) and sexuality (reproduction): Who am I, and what can I be? Teenagers invent and reinvent themselves. They try to stand out, and they try to fit in. They may anguish over their body image as they develop secondary sex characteristics. They may experiment with drugs or engage in other risky behaviors. They compare their family ’s values to those of their peers and mentors. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Benjamin Silverberg Tags: Preface Source Type: research

Adolescent Medicine
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Authors: Benjamin Silverberg Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Source Type: research

Contributors
Joel J. Heidelbaugh, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Source Type: research

Primary Care: Clinics in Office Practice
Immunizations (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 16, 2020 Category: Primary Care Source Type: research

Preparticipation Evaluation
Although the specific content has been recommended, debated, and extensively reviewed over the past several decades, the preparticipation evaluation (PPE) has become standard of care for athletes as they prepare for organized athletic participation. The PPE seeks to detect conditions that predispose the athlete to injury or limit full participation in certain activities. Of particular interest, underlying cardiovascular and musculoskeletal conditions are sought because they are frequently associated with mortality and morbidity in athletes. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Stephen M. Carek, Katherine M. Edenfield, Peter J. Carek Source Type: research

Principles of Rehabilitation
Developing and implementing a rehabilitation program is one of the most challenging patient care skills because it requires a firm grasp of the healing process and available treatment options, which must then be serially compared with the pathologic condition of the injury and the patient ’s progress. This cyclical problem-based approach to rehabilitation allows clinicians to most effectively individualize the rehabilitation plan to the patient’s individual needs and progress. In each phase of the rehabilitation process, problems should be identified and goals developed taking in to consideration the phase of h...
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Michelle Futrell, Susan L. Rozzi Source Type: research

Acute Sports-Related Head Injuries
Injuries from sports-related head trauma are commonly encountered by primary care providers. These injuries vary in clinical presentation, severity, and outcome, with sports-related concussion (SRC) being the most common and more severe sports-related head trauma, such as hemorrhage, and “second impact syndrome” occurring rarely. Understanding the importance of immediate recognition, removal from play, multimodal evaluation, and typical patterns of recovery is necessary to safely manage an athlete with SRC. Proper care of athletes with severe sports-related head trauma requires a high index of suspicion and app...
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Stephen M. Carek, James R. Clugston Source Type: research

Common Medical Concerns of the Female Athlete
Women are increasingly participating in more and more sporting activities. For years, women athletes have been treated as the “female” equivalent of male athletes, with similar medical approaches but this is changing. The concept that women are unique in their “athletic arena” is further underscored with emerging scientific evidence––from the physiologic details not visible to the eye, to the more overt biomech anical and anatomic differences. We review a handful of conditions active women potentially may encounter: pregnancy, the female athlete triad, patellofemoral pain, potential inju...
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Siobhan M. Statuta, Colton L. Wood, Lisa K. Rollins Source Type: research

Every Patient Seen in Primary Care Is an Athlete (to a Degree)
As primary care physicians, advance practice providers, or other members of the health care team, we recommend physical activity to most if not all patients we see. On a population basis, and most importantly, regular physical activity prevents the development of coronary artery disease and reduces symptoms in patients with established cardiovascular disease. Furthermore, evidence supports the role of exercise in reducing the risk of several other chronic diseases, including type 2 diabetes mellitus, osteoporosis, obesity, and cancer of the breast and colon. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Peter J. Carek Tags: Preface Source Type: research

Aches and Pains, Goals, and Gains
Many of us at 1 point or another in our lives have considered ourselves to be athletes, or at least “athletic.” Even if we haven’t, life is full of activities, chores, and work: all of which create an element of physical stress and strain often when we least expect it. Sore necks and backs abound coupled with the random joint and even foot pain, created by physical activity, sitting at a com puter, or something as simple as lifting a laundry basket. One of the most brutal injuries I’ve sustained in my first half-century of life involved lifting: a sock that I dropped on the floor. (Source: Primary C...
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Sports Medicine
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Authors: Peter J. Carek Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Source Type: research

Forthcoming Issues
Adolescent Medicine (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - February 1, 2020 Category: Primary Care Source Type: research

Sports Supplements
Sports supplements can be generally divided into 3 categories: sports foods (foods/drinks containing macronutrients), medical supplements (vitamins/minerals used to treat deficiencies), and ergogenic supplements (used to benefit performance). Supplements are not regulated by the US Food and Drug Administration. They may get to the market and be contaminated with substances banned in sport or dangerous to health; and the contents may not contain what is listed on the label. When choosing to use a supplement, the safest practice is to choose a certified brand, which tests and authenticates label verification, quality, and la...
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: Katherine M. Edenfield Source Type: research

Common Prescription Medications Used in Athletes
Athletes of various skill levels commonly use many different types of medications, often at rates higher than the general population. Common medication classes used in athletes include analgesics such as nonsteroidal anti-inflammatory drugs and acetaminophen, inhalers for asthma and exercise-induced bronchoconstriction, antihypertensives, antibiotics, and insulin. Prescribers must be aware of the unique considerations for each of these medications when using them in patients participating in physical activity. The safety, efficacy, impact on athletic performance, and regulatory restrictions of the most common medications u...
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: Benjamin Ferry, Alexei DeCastro, Scott Bragg Source Type: research

Common Upper-Extremity Injuries
This article aims to educate physicians about sports-related upper-extremity injuries. Common mechanisms of injury, classic physical examination, and radiographic findings are reviewed. General guidelines for treatment as well as indications for referral to a sports medicine or orthopedic specialist are included in the discussion. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: Alexei DeCastro Source Type: research

Hip and Knee Injuries
This article discusses several of the most common causes for hip and knee pain while providing an evidence based review of physical examination maneuvers, imaging studies and treatment modalities to assist a primary care provider when encountering active patients with underlying hip o r knee pain. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: Stephen M. Carek Source Type: research

Approaching Foot and Ankle Injuries in the Ambulatory Setting
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. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: Andrew W. Albano, Vicki Nelson Source Type: research

Back Injuries
This article reviews the demographics, diagnostic challenges, history and physical examination, imaging choices, treatment, and controversies encountered when treating this population. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 23, 2019 Category: Primary Care Authors: James M. Daniels, Cesar Arguelles, Christopher Gleason, William H. Dixon Source Type: research