Are DMARDs effective for rheumatologic diseases besides rheumatoid arthritis?

It's unclear whether disease-modifying antirheumatic agents (DMARDs) as first-line therapy in nonrheumatoid rheumatologic diseases are effective because the question has not been studied. As second-line therapy, the use of some DMARDs appears to be beneficial for patients with psoriatic arthritis (strength of recommendation [SOR: A, based on systematic reviews of good- quality randomized controlled trials) and ankylosing spondylitis (SOR: B, based on systematic reviews of moderate quality trials). Data on the safety and efficacy of DMARDs as second-line therapy for other arthritic conditions is limited (SOR: C, based on small prospective cohort trials)

What is the best way to screen for breast cancer in women with implants?

Mammography is best. It is considered as effective for screening women who have undergone augmentation mammoplasty as those who have not (strength of recommendation [SOR]: B, limited number of retrospective and prospective cohort studies). This question has not been well studied, however

What's the best way to manage upper extremity venous thrombosis?

Standard management is best: Start with unfractionated heparin or low-molecular-weight heparin and follow with long-term therapy with a vitamin K antagonist (strength of recommendation [SOR]: C, expert consensus and case reports). Some evidence supports thrombolytic therapy, placement of a superior vena cava filter, or surgical thrombectomy in selected patients (SOR: C, expert consensus and case reports). Whether to remove venous catheters during initial treatment for catheter-induced venous thrombosis remains unclear, because limited studies address this issue specifically (SOR: C, expert consensus and case reports)

Antibody Testing for Systemic Lupus Erythematosus

Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE. (Strength of Recommendation: C, based on expert opinion.) The antinuclear antibody (ANA) test is the most commonly used screening test for SLE. The presence of anti-DNA, anti-Sm, and antiphospholipid antibodies is more specific for diagnosing SLE

How accurate is an MRI at diagnosing injured knee ligaments?

MRI is highly accurate in diagnosing injury to the anterior cruciate ligament (ACL) (strength of recommendation [SOR]: A, prospective blinded cohort studies) and posterior cruciate ligament (PCL) (SOR: B, limited number of prospective blinded cohort studies). Insufficient data are available to evaluate the effectiveness of magnetic resonance imaging (MRI) for diagnosing injuries to the medial collateral ligament (MCL) and lateral collateral ligament (LCL)

Managing Intoeing in Children

Intoeing can be accurately diagnosed using a history, physical examination, and torsional profile. (Strength of Recommendation [SOR]: C, based on expert consensus.) The three most common causes of intoeing (i.e., metatarsus adductus, internal tibial torsion, and increased femoral anteversion) initially should be managed conservatively with serial examinations and reassurance. (SOR: C, based on expert consensus.) Patients with rigid metatarsus adductus should have serial casting if it persists beyond six months of age. (SOR: C, based on expert consensus.) Patients with internal tibial torsion that persists into midchildhood should be referred for surgical correction. (SOR: C, based on expert consensus.) Patients with increased femoral anteversion that persists past eight to 10 years of age should be referred for surgical correction. (SOR: C, based on expert consensus.