Pain can't be carved at the joints: defining function-based pain profiles and their relevance to chronic disease management in healthcare delivery design.

Background: Pain is a complex problem that is triaged, diagnosed, treated, and billed based on which body part is painful, almost without exception. While the "body part framework" guides the organization and treatment of individual patients' pain conditions, it remains unclear how to best conceptualize, study, and treat pain conditions at the population level. Here, we investigate (1) how the body part framework agrees with population-level, biologically derived pain profiles; (2) how do data-derived pain profiles interface with other symptom domains from a whole-body perspective; and (3) whether biologically derived pain profiles capture clinically salient differences in medical history.

Dynamic Instability Is Underestimated on Standing Flexion-Extension Films When Compared With Prone CT Imaging.

Study Design/setting: Single center retrospective cohort study.

Objective: We performed a retrospective study evaluating the incidence and degree of L4-5 anterior spondylolisthesis in patients with standard supine MRI, standing flexion-extension radiographs, and prone CT. We hypothesize that prone CT imaging will provide greater sensitivity for instability compared with conventional flexion extension or supine positions.

Shoulder pathology on advanced imaging in asymptomatic non-athlete individuals: A narrative review.

The prevalence of asymptomatic shoulder pathology has been shown to be high on both ultrasound and magnetic resonance imaging (MRI). The most common shoulder pathologies identified in asymptomatic, non-athlete individuals include rotator cuff pathology, acromioclavicular (AC) joint pathology, labral tears, subacromial bursitis, and calcific tendinitis. The data in the current literature suggest that asymptomatic rotator cuff tears are diagnosed on ultrasound and MRI at high rates, suggesting that rotator cuff tears may be considered an age-related, normal, degenerative change.

The Pain Intervention & Digital Research Program: an operational report on combining digital research with outpatient chronic disease management.

Chronic pain affects up to 28% of U.S. adults, costing ∼$560 billion each year.

A circulating vaccine-derived poliovirus type 2 outbreak in a chronic conflict setting: a descriptive epidemiological study in South Sudan - 2020 to 2021.

Background: In this study, we describe the epidemiological profile of an outbreak of the circulating Vaccine Derived Polio Virus type 2 in South Sudan from 2020 to 2021.

Method: We conducted a retrospective descriptive epidemiological study using data from the national polio/AFP surveillance database, the outbreak investigation reports, and the vaccination coverage survey databases stored at the national level.

Results: Between September 2020 and April 2021, 59 cases of the circulating virus were confirmed in the country, with 50 cases in 2020 and 9 cases in 2021.

Comprehensive Grading System of Inflammatory Features of the Lumbar Facet Joints on Magnetic Resonance Imaging.

Study Design: Retrospective.

Objective: We aimed to describe a magnetic resonance imaging (MRI)-based grading system of inflammatory features of the lumbar facet joints using an atlas and assess its reliability.

Summary Of Background Data: Chronic low back pain is often caused by facet joint arthropathy.

Grading Systems of Lumbar Facet Joint Inflammatory Changes on Magnetic Resonance Imaging: A Scoping Review.

Study Design: A scoping review.

Objective: We aimed to identify and characterize grading systems of the inflammatory features of the lumbar facet joints (FJs) noted on magnetic resonance imaging and summarize their reliability.

Summary Of Background Data: Chronic low back pain is one of the most common causes of disability worldwide and is frequently accompanied by FJ osteoarthritis.

Measles outbreak investigation in Aweil East county, South Sudan.

During January 2018-June 2020, Aweil East confirmed five measles outbreaks. In March 2020, Aweil East reported twenty measles IgM+ cases. Before this outbreak, Aweil East had confirmed an outbreak in late November 2019.

Simplified Universal Grading of Lumbar Spine MRI Degenerative Findings: Inter-Reader Agreement of Non-Radiologist Spine Experts.

Objective: 1) To describe a simplified multidisciplinary grading system for the most clinically relevant lumbar spine degenerative changes. 2) To measure the inter-reader variability among non-radiologist spine experts in their use of the classification system for interpretation of a consecutive series of lumbar spine magnetic resonance imaging (MRI) examinations.

Methods: ATS multidisciplinary and collaborative standardized grading of spinal stenosis, foraminal stenosis, lateral recess stenosis, and facet arthropathy was developed.

Atlanto-axial Pannus in Patients with and without Rheumatoid Arthritis.

Objective: Pannus formation in the atlanto-axial joint is a well-recognized complication of rheumatoid arthritis (RA). Occasionally, atlanto-axial pannus is reported when patients without a history of RA undergo magnetic resonance imaging (MRI) of the cervical spine. We sought to further characterize these patients.

Prevalence of Hepatitis B surface antigen among biomedical students of African descent in Usmanu Danfodiyo University, Sokoto, Nigeria.

Background: Hepatitis B (HB) is a serious global public health problem that put health professionals particularly at risk.

Objective: The aim of this study was to investigate the prevalence of Hepatitis B surface antigen (HBsAg) among Biomedical Students of African descent attending Usmanu Danfodiyo University Sokoto in North-Western Nigeria.

Methods: The Onsite HBsAg (CTK Biotech, USA) was used to detect the presence of hepatitis B surface antigen.

Changes in Pain Sensitivity and Pain Modulation During Oral Opioid Treatment: The Impact of Negative Affect.

Objective: Opioids are frequently prescribed for chronic low back pain (CLBP), but there are broad individual differences in the benefits and risks of opioid therapy, including the development opioid-induced hyperalgesia. This study examined quantitative sensory testing (QST) data among a group of CLBP patients undergoing sustained oral opioid treatment. We investigated whether individual differences in psychological characteristics were related to opioid-induced changes in pain perception and pain modulation.

Psychiatric Comorbidity Is Associated Prospectively with Diminished Opioid Analgesia and Increased Opioid Misuse in Patients with Chronic Low Back Pain.

Background: Opioids are frequently prescribed for chronic low back pain (CLBP), but there are little prospective data on which patient subgroups may benefit. Psychiatric comorbidity, such as high levels of depression and anxiety symptoms (termed comorbid negative affect [NA]), is a common presentation and may predict diminished opioid analgesia and/or increased opioid misuse.

Methods: The authors conducted a 6½-month prospective cohort study of oral opioid therapy, with an active drug/placebo run-in period, in 81 CLBP patients with low, moderate, and high levels of NA.

Are facet joint bone marrow lesions and other facet joint features associated with low back pain? A pilot study.

Objective: To determine the frequency of facet joint (FJ) bone marrow lesions, high FJ periarticular signal intensity, and FJ effusions in a convenience sample of patients with axial low back pain (LBP).

Design: A cross-sectional pilot study with retrospective data collection.

Setting: Outpatient spine clinics.

When should a cervical collar be used to treat neck pain?

Neck pain is one of the most prevalent and costly health problems in the United States. It remains a complex, subjective experience with a variety of musculoskeletal causes. Although, cervical collars are a seemingly benign intervention, they can have adverse effects, especially when used for longer periods of time.

The role of intradiscal steroids in the treatment of discogenic low back pain.

LBP is one of the most common reasons for visiting a doctor and is the most common cause of disability under age 45.Amongst a variety of etiologies, internal disc disruption (IDD) has been postulated as an important cause of low back pain. Treating discogenic low back pain continues to be a challenge to physicians.

Clean versus sterile technique for common joint injections: a review from the physiatry perspective.

Preparation of the skin prior to joint injection varies widely among disciplines and across regional borders. This is likely due to the paucity of literature on the most effective and efficient methods of preparation. There is no standard definition of clean technique prior to joint injection.

Discography in practice: a clinical and historical review.

Chronic low back pain is the most common cause of disability in individuals between the ages of 45 and 65. Given the variety of anatomic and pathophysiologic causes of persistent low back pain, it is a difficult diagnosis for clinicians to treat. Discography is a diagnostic option that may link a patient's subjective complaints of spinal pain to symptomatic disk disease when non-invasive imaging, such as magnetic resonance imaging (MRI), does not find structural abnormalities.