Acute ankle sprains are a common musculoskeletal injury. As part of the physical examination, a combination of ankle-specific tests should be used to evaluate ligaments. Delaying the examination until 4 to 7 days postinjury increases diagnostic accuracy of sprain severity. In the acute setting, the Ottawa Foot and Ankle rules can help determine when radiography does not need to be ordered to evaluate for fracture. Management of acute ankle sprains should include joint protection, pain control, external ankle supports for 5 to 10 days, early functional activity, and targeted rehabilitation exercises. Oral medications such as acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids are equally effective in managing pain. Recovery includes the use of external ankle supports (eg, semirigid braces) and a targeted neuromuscular rehabilitation program for 8 to 12 weeks. Continuing functional exercises and the use of external ankle support during sport after recovery can aid in the prevention of recurrent ankle sprains. If an ankle sprain does not follow the expected course of recovery, further evaluation with magnetic resonance imaging should be performed to evaluate for other causes of acute lateral ankle injuries, such as talar fractures and peroneal tendon injuries.
{"title":"Management of Acute Ankle Sprains: Common Questions and Answers.","authors":"Velyn Wu, Cheree Ann Padilla, Nicholas A Smith","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute ankle sprains are a common musculoskeletal injury. As part of the physical examination, a combination of ankle-specific tests should be used to evaluate ligaments. Delaying the examination until 4 to 7 days postinjury increases diagnostic accuracy of sprain severity. In the acute setting, the Ottawa Foot and Ankle rules can help determine when radiography does not need to be ordered to evaluate for fracture. Management of acute ankle sprains should include joint protection, pain control, external ankle supports for 5 to 10 days, early functional activity, and targeted rehabilitation exercises. Oral medications such as acetaminophen, nonsteroidal anti-inflammatory drugs, and opioids are equally effective in managing pain. Recovery includes the use of external ankle supports (eg, semirigid braces) and a targeted neuromuscular rehabilitation program for 8 to 12 weeks. Continuing functional exercises and the use of external ankle support during sport after recovery can aid in the prevention of recurrent ankle sprains. If an ankle sprain does not follow the expected course of recovery, further evaluation with magnetic resonance imaging should be performed to evaluate for other causes of acute lateral ankle injuries, such as talar fractures and peroneal tendon injuries.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"609-617"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Honoring 75 Years of Connection and Commitment.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"597"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidental Activity Is Associated With Large Reductions in Cardiovascular Events and Mortality.","authors":"Mark H Ebell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"692-693"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sofpironium Topical Gel Is Effective for Axillary Hyperhidrosis.","authors":"David C Slawson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"691-692"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E Seth Kramer, Melissa N Johnson, Bradford Winslow
Dementia is a major neurocognitive disorder involving deficits that interfere with daily function. Age is the greatest risk factor for developing the disease. Other risk factors include family history, cardiovascular disease, uncontrolled diabetes, and lower education levels. The initial evaluation for dementia involves recognizing subtle signs that are often missed or mistaken for normal aging. Screening tools include the Mini-Cog, Memory Impairment Screen (MIS), and questionnaires that are completed by caregivers or friends. If cognitive impairment is suspected, a more detailed evaluation should be performed using tools such as the Montreal Cognitive Assessment (MoCA), Saint Louis University Mental Status (SLUMS), or Rowland Universal Dementia Assessment Scale (RUDAS). A thorough history should be taken and a medication review and physical examination should be performed for the assessment of vision; hearing; cardiovascular, nutritional, and functional status; neurologic function; and psychiatric status. Laboratory testing, such as vitamin B12 and folate levels, thyroid function, complete blood cell count, and comprehensive metabolic panel, may be necessary to rule out underlying conditions. Brain imaging with noncontrast magnetic resonance imaging (or non-contrast computed tomography of the head if magnetic resonance imaging is unavailable or contraindicated) can rule out secondary causes. Differentiating dementia from potentially reversible conditions such as depression and delirium is essential. Referral to a neurologist is recommended for early-onset symptoms (before 60 years of age), for severe behavioral disturbances, or if the diagnosis is unclear.
{"title":"Evaluation of Suspected Dementia.","authors":"E Seth Kramer, Melissa N Johnson, Bradford Winslow","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dementia is a major neurocognitive disorder involving deficits that interfere with daily function. Age is the greatest risk factor for developing the disease. Other risk factors include family history, cardiovascular disease, uncontrolled diabetes, and lower education levels. The initial evaluation for dementia involves recognizing subtle signs that are often missed or mistaken for normal aging. Screening tools include the Mini-Cog, Memory Impairment Screen (MIS), and questionnaires that are completed by caregivers or friends. If cognitive impairment is suspected, a more detailed evaluation should be performed using tools such as the Montreal Cognitive Assessment (MoCA), Saint Louis University Mental Status (SLUMS), or Rowland Universal Dementia Assessment Scale (RUDAS). A thorough history should be taken and a medication review and physical examination should be performed for the assessment of vision; hearing; cardiovascular, nutritional, and functional status; neurologic function; and psychiatric status. Laboratory testing, such as vitamin B12 and folate levels, thyroid function, complete blood cell count, and comprehensive metabolic panel, may be necessary to rule out underlying conditions. Brain imaging with noncontrast magnetic resonance imaging (or non-contrast computed tomography of the head if magnetic resonance imaging is unavailable or contraindicated) can rule out secondary causes. Differentiating dementia from potentially reversible conditions such as depression and delirium is essential. Referral to a neurologist is recommended for early-onset symptoms (before 60 years of age), for severe behavioral disturbances, or if the diagnosis is unclear.</p>","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"657-667"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"BP Target Should Be a Shared Decision That Balances Benefits and Harms.","authors":"Mark H Ebell, David C Slawson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"598-599"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Samsung Health Monitor App for the Detection of Obstructive Sleep Apnea.","authors":"Carl Bryce, Alec Oliva","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"674-675"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Suzetrigine Was More Effective Than Placebo and Similar to Hydrocodone-Acetaminophen, 5 mg/325 mg for Postoperative Pain.","authors":"Mark H Ebell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"691"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessing the Risk of Heart Failure With Preserved Ejection Fraction in Individuals With Exertional Dyspnea.","authors":"Aaron Saguil, Petra Townsend, Mark H Ebell","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7713,"journal":{"name":"American family physician","volume":"112 6","pages":"686-687"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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