Revue médicale suisse
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Revue médicale suisse · Aug 2010
[When should a patient with low back pain/sciatica be referred to the emergency ward?].
Low back pain and sciatica are common causes of medical consultation. The medical history and the physical examination are essential in their management. ⋯ These include hyperalgic sciatica, sciatica with motor deficits and the cauda equina syndrome. Sciatica with sensory deficits do not require emergency department referral.
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Revue médicale suisse · Aug 2010
[When should a patient with musculoskeletal trauma be referred to emergency ward?].
Standardized clinical examination can obviate the need for osteoarticular radiographs for trauma. This paper summarizes a number of decision rules that allow clinical exclusion of significant fracture of the cervical spine, elbow, knee or ankle, making radiographs unnecessary. These criteria were all derived from large cohort studies (Nexus, Ottawa, CCS, etc..., and have been prospectively validated. The rigorous use of these criteria in daily practice improves treatment times and costs with no adverse effect on treatment quality.