Postural tremor occurs when the affected body part maintains position against gravity (e.g., extending arms in front of body). Isometric tremor results from muscle contraction against stationary objects (e.g., squeezing the examiner’s fingers). Kinetic tremor, which occurs with voluntary movement, is either simple kinetic tremor or intention tremor. Simple kinetic tremor is associated with move...

Cutaneous manifestations of dermatomyositis are generally grouped as pathognomonic, characteristic, compatible, less common and rare (Table 4). The primary lesion appears as a violaceous, macular erythema with a symmetric distribution. This may progress and become poikilodermatous (atrophic with telangiectasia and pigmentary changes) and indurated (as a result of mucin deposition). Pathognomoni...

H awthorn, a Crataegus species, is part of a genus of spiny shrubs and trees native to temperate regions in the Northern Hemisphere in Europe, Asia, and North America. Depending on the taxonomic interpretation, between 200 and 1,000 species of Crataegus have been recognized. Hawthorn is the oldest known medicinal plant in European medicine; its actions on the heart were first described by Diosc...

A bout 218,890 new prostate cancer diagnoses were expected in the United States during 2007, with 27,050 men dying of the disease. Men have a 17 percent lifetime risk of prostate cancer, but only a 3 percent risk of dying from the disease. Black men have the highest incidence of prostate cancer in the world. The age-adjusted death rate from prostate cancer is 64.4 per 100,000 for black men comp...

P eripheral nerve injury in the upper extremity is common, and certain peripheral nerves are at an increased risk of injury because of their anatomic location. Risk factors include a superficial position, a long course through an area at high risk of trauma, and a narrow path through a bony canal. The anatomy and function of upper extremity nerve roots, as well as specific risk factors of injur...

R ecognition and diagnosis of tongue abnormalities require examination of tongue morphology and a thorough history, including onset and duration, antecedent symptoms, and tobacco and alcohol use. A complete head and neck examination, with careful assessment for lymphadenopathy, is essential. According to the National Health and Nutrition Examination Survey, the point prevalence of tongue lesion...

the pelvis and lumbar spine. Although the spondyloarthropathies are grouped together, they display distinct clinical features. It is likely that an interplay among genetic, environmental, and immunologic factors is responsible for the various clinical manifestations of these diseases. Infection with an unknown organism or exposure to an unknown antigen in a genetically susceptible patient (HLA-...

This clinical content conforms to AAFP criteria for evidence-based continuing medical education (EB CME). EB CME is clinical content presented with practice recommendations supported by evidence that has been systematically reviewed by an AAFP-approved source. P rimary dysmenorrhea, which is defined as painful menses in women with normal pelvic anatomy, usually begins during adolescence. It is ...