Spine
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A retrospective case review was performed. ⋯ In neurologically normal patients, the combined methods are safe and rapid, and could improve the sensitivity and specificity of scoliosis monitoring. Arm controls facilitate differentiation between systemic alterations and focal neurologic compromise.
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Initial assessment involved 360 patients (90% women and 10% men) attending spinal and internal medicine clinics over a 6-year period who had experienced low back pain that had no obvious cause for more than 6 months. The patients ranged in age from 15 to 52 years. ⋯ Vitamin D deficiency is a major contributor to chronic low back pain in areas where vitamin D deficiency is endemic. Screening for vitamin D deficiency and treatment with supplements should be mandatory in this setting. Measurement of serum 25-OH cholecalciferol is sensitive and specific for detection of vitamin D deficiency, and hence for presumed osteomalacia in patients with chronic low back pain.
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A cross-sectional survey using patient questionnaires was conducted. OBJECTIVE To assess whether the Roland Disability Questionnaire satisfies the Rasch model including unidimensionality and item separation. ⋯ The Roland Disability Questionnaire largely satisfies the Rasch model for unidimensionality. However, the instrument could be improved through the removal of poorly fitting items and the addition of items at the upper and lower points of the scale hierarchy. The distribution of Roland Disability Questionnaire scores should be carefully considered before statistical testing is undertaken. Rasch transformed scores can be used to deal with deficiencies in the scale hierarchy.
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Familial cases of "idiopathic" scoliosis associated with neurologic abnormalities are reported with a review of the literature. ⋯ It is suggested that familial neurologic abnormalities may have a wide range of expression, and that some patients with "idiopathic" scoliosis present with genetically determined craniovertebral malformations such as syringomyelia, Chiari 1 malformation, and tonsillar ectopia.
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Clinical Trial
Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy.
A blinded, prospective diagnostic test study was conducted. ⋯ Many items of the clinical examination were found to be reliable and to have acceptable diagnostic properties, but the test item cluster identified was more useful for indicating cervical radiculopathy than any single test item. Upper limb tension Test A was the most useful test for ruling out cervical radiculopathy. Further investigation is required both to validate the test item cluster and to improve point estimate precision.