Guideline concordant care for acute low back pain: A mixed-methods analysis of determinants of implementation.

Introduction: We conducted an explanatory, sequential mixed-methods study to measure variation in the use of imaging and physical therapy (PT) for acute low back pain (LBP) and to identify implementation determinants that might explain variation in use across 22 EDs and 27 urgent cares in urban and rural locations within a community-based health system.

Methods: We described the patient population and measured concordance with LBP guideline recommendations on imaging and PT referral from January-June 2023. We conducted key informant interviews with physicians and advanced practice providers (APPs), n = 30, from these 49 sites between July - September 2023 and performed content analysis to identify implementation determinants to guideline concordance.

The Froment-Rauber nerve: a case report and review.

Introduction: The Froment-Rauber nerve is a rarely described anomalous nerve arising from 1 of the terminal branches of the radial nerve that provides innervation to intrinsic hand muscles. We describe a 26-year-old man who had a traumatic radial nerve injury that resulted in first dorsal interosseous muscle wasting. He presented to our clinic 2.

Absent inferior vena cava resulting in exercise-induced epidural venous plexus congestion and lower extremity numbness: a case report and review of the literature.

Study Design: Case report and clinical discussion.

Objective: To describe a unique etiology for a patient presenting with exercise-induced lower extremity numbness found to have agenesis of the infrarenal inferior vena cava (IVC) and a large vein draining the confluence of the iliac veins through the L4 foramen into the epidural plexus.

Summary Of Background Data: Epidural venous abnormalities are infrequently determined to be the etiology of nerve root compression syndromes.

Analgesic benefit of niacin for shrapnel wound pain in war veteran.

We report a case of an 86-year-old male with a history of dyslipidemia, which had been treated with a medication regimen that included niacin. Upon discontinuation of niacin by his physician, he noticed recurrence of aching pain on the dorsal surface of the foot where he had a scar from a World War II shrapnel injury. With reinitation of niacin, his pain again abated.