Long-Term Retention of Musculoskeletal Ultrasound Training During Residency.

The Accreditation Council for Graduate Medical Education and the American Board of Physical Medicine and Rehabilitation developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation residents at a large academic medical center.

Increased Reliability of Quantitative Ultrasound Measures of the Supraspinatus Tendon Using Multiple Image Analysts and Analysis Runs.

Quantitative ultrasound (QUS) is an inexpensive and promising tool for sensitive measurement of tendon pathology. However, few studies have reported the psychometric properties of measurements obtained using this technique for assessments of the supraspinatus tendon. The present study was undertaken to determine the variance contributed by several sources of error (participant, ultrasound operator, image analyst, analysis session) to QUS measures of the supraspinatus tendon.

Two Unique Cases of Ciprofloxacin-Associated Avulsion of Ligament and Tendon.

Ciprofloxacin is recognized to have a deleterious relationship with tendons, particularly Achilles tendinopathy, which makes up most case reports. Tendinopathy seems to occur because of induction of collagen-degrading enzymes causing damage and ischemia of the poorly vascularized regions preventing repair. The focus on the relationship of ciprofloxacin and the Achilles tendon leaves patients on fluoroquinolones with non-Achilles tendinopathy symptoms at risk of misdiagnosis.

Assessment of neuromuscular conditions using ultrasound.

Upper extremity pain in persons with spinal cord injury is a common cause of morbidity. Ultrasound of nerve, muscle, and tendon has the potential to become a valuable modality in assessing this population, and has the advantage of reduced health care costs, portability, and use in populations that cannot tolerate MRI. It has the potential to detect issues before the onset of significant morbidity, and preserve patient independence.

Neurosarcoidosis presenting as mononeuritis multiplex.

Sarcoidosis is a multisystem granulomatous disease of unknown etiology, with prevalence ranging from 1 to 50 per 100,000. Neurologic involvement occurs in up to 5% of patients but can be the initial presentation of sarcoidosis in 50% of those affected by neurosarcoidosis. The authors report a case of mononeuritis multiplex of the ulnar and then the radial nerve that subsequently led to a diagnosis of sarcoidosis in a patient 8 mos after initial presentation.

Industrial medicine and acute musculoskeletal rehabilitation. 7. Acute industrial musculoskeletal injuries in the aging workforce.

Unlabelled: This learning module highlights the unique challenges faced by physicians treating the aging workforce. It is part of the industrial medicine and acute musculoskeletal rehabilitation study guide in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Factors intrinsic and extrinsic to the patient that increase the risk of injury with aging are outlined.

Industrial medicine and acute musculoskeletal rehabilitation. 6. Upper- and lower-limb injections for acute musculoskeletal injuries and injured workers.

Unlabelled: This self-directed study module focuses on the use of corticosteroids and other injections in the treatment of lateral epicondylitis, de Quervain's tenosynovitis, carpal tunnel syndrome, Achilles' tendinitis, and plantar fasciitis. It is part of the study guide on industrial rehabilitation medicine and acute musculoskeletal rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation.

Overall Article Objective: To review the medical literature to help clinicians make treatment decisions regarding corticosteroid and other injections in the upper and lower limbs in injured workers.

Industrial medicine and acute musculoskeletal rehabilitation. 5. Interventional procedures for work-related lumbar spine conditions.

Unlabelled: This chapter emphasizes the importance of establishing a differential diagnosis for low back pain (LBP) with and without referred lower-limb pain and outlines potential interventional treatments appropriate for each diagnosis. It is part of the study guide on industrial rehabilitation and acute musculoskeletal rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. The article specifically focuses on the various interventions used to diagnose or treat those conditions commonly seen in patients with work-related LBP or referred pain in the lower limb.

Industrial medicine and acute musculoskeletal rehabilitation. 3. Work-related musculoskeletal conditions: the role for physical therapy, occupational therapy, bracing, and modalities.

Unlabelled: This chapter focuses on the use of modalities, therapeutic exercise, and orthotic devices in the treatment of lateral epicondylitis, carpal tunnel syndrome, plantar fasciitis, neck pain and low back pain. It is part of the study guide on industrial rehabilitation medicine and acute musculoskeletal rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation.

Overall Article Objective: To review the medical literature that may help clinicians make treatment decisions regarding modalities, therapeutic exercise, and orthotic devices for treating common work-related conditions in the upper and lower limbs.

Industrial medicine and acute musculoskeletal rehabilitation. 2. Medications for the treatment of acute musculoskeletal pain.

Unlabelled: This self-directed learning module highlights medications used in the treatment of acute musculoskeletal pain in the context of industrial rehabilitation. It is part of the study guide on industrial rehabilitation medicine and acute musculoskeletal rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article compares various skeletal muscle relaxants, addresses issues related to nonsteroidal anti-inflammatory medications, provides an algorithm for acute pain management in an injured worker, and discusses topical medications for the treatment of pain.

Age, body mass index, and gender differences in sacroiliac joint pathology.

Objective: To evaluate the correlation between age, gender, and body mass index as they relate to sacroiliac joint pathology diagnosed by dual comparative local anesthetic blocks.

Design: This was a retrospective review of patients at a university spine center from August 2001 until August 2004.

Results: One hundred fifty-eight patients underwent sacroiliac joint (SIJ) injections with average symptom duration of 34.

Concomitant sacroiliac joint pain in patients with lumbar disc herniation: case series.

Recent studies have shown that not all lumbar disc herniations are symptomatic and that when followed longitudinally, these patients develop back pain independent of the previous imaging study. This is a case report of two patients with radicular symptoms and lumbar disc herniations that underwent diagnostic injections to locate their pain generator. Both patients failed to respond to transforaminal epidural steroid injections.