The Journal of orthopaedic and sports physical therapy
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J Orthop Sports Phys Ther · Feb 2019
Case ReportsCervical Fracture With Posterior Ligamentous Injury While Skydiving.
A 46-year-old male soldier reported to an emergency department with severe acute neck pain immediately following a hyperflexion injury during recreational skydiving. He was evaluated in the emergency department, including radiographs, and released with a diagnosis of "acute neck strain." After presenting with continued neck pain, he was sent for consultation with a physical therapist. ⋯ In addition, the radiologist recommended computed tomography and magnetic resonance imaging, which confirmed bilateral C6 lamina fractures and multiple ligamentous disruption at C5-6. J Orthop Sports Phys Ther 2019;49(2):113. doi:10.2519/jospt.2019.8360.
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A 51-year-old woman presented to physical therapy with complaints of weakness in her left arm, progressive numbness in both hands, and mild progressive neck pain radiating into the left upper arm. She reported that her condition had started after playing in an amateur tennis tournament 4 weeks prior and progressed to inability to play tennis. Following examination by the physical therapist, the patient was referred to her physician, who ordered magnetic resonance imaging of the spine, which showed a bony exostosis at C1-2 with myelopathy. J Orthop Sports Phys Ther 2019;49(2):112. doi:10.2519/jospt.2019.7942.
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J Orthop Sports Phys Ther · Jan 2019
Case ReportsIntra-articular Chondral Fragment After Acute Patellar Dislocation.
An 18-year-old military cadet presented to a direct-access physical therapy clinic 3 days after sustaining a lateral patellar dislocation that self-reduced with extension of the knee. Suspecting a loose body, the physical therapist ordered radiographs, which did not demonstrate any associated fractures. ⋯ Magnetic resonance imaging demonstrated a full-thickness defect in the patellar cartilage at the medial facet, with a loose fragment in the suprapatellar pouch. J Orthop Sports Phys Ther 2019;49(1):36. doi:10.2519/jospt.2019.7599.
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J Orthop Sports Phys Ther · Jan 2019
Case ReportsPlexiform Neurofibromatosis in a Woman With a Pubic Ramus Stress Fracture.
A 22-year-old woman in Army Basic Combat Training was evaluated in a physical therapy clinic for insidious-onset groin pain. The referring primary care physician assistant ordered initial radiographs, which were noncontributory, followed by a bone scan that indicated a left inferior pubic ramus stress fracture. ⋯ Due to the palpable mass and severe pain upon return, the physical therapist ordered magnetic resonance imaging, which showed plexiform neurofibromas, with a left buttock mass and left inferior pubic ramus stress fracture. J Orthop Sports Phys Ther 2019;49(1):37. doi:10.2519/jospt.2019.7495.
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J Orthop Sports Phys Ther · Dec 2018
Reliability of the Mechanical Diagnosis and Therapy System in Patients With Spinal Pain: A Systematic Review.
An updated summary of the evidence for the reliability of the Mechanical Diagnosis and Therapy (MDT) system in patients with spinal pain is needed. ⋯ The MDT system appears to have acceptable interrater reliability for classifying patients with back pain into main and subsyndromes when applied by therapists who have completed the credentialing examination, but unacceptable reliability in other therapists. We found conflicting evidence regarding the reliability of the MDT system in patients with neck pain or mixed pain locations. J Orthop Sports Phys Ther 2018;48(12):923-933. Epub 22 Jun 2018. doi:10.2519/jospt.2018.7876.