American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Feb 2016
Residency and Beyond: Subspecialization Trends Among Graduating Physiatry Residents and the Musculoskeletal Curriculum.
Previous studies and informal surveys have demonstrated a trend among graduating physiatry residents who desired to practice in an outpatient musculoskeletal (MSK)- or spine-type setting. However, there has been no updated information on the current trend among graduating residents as well as sparse information on gauging if current trainees feel prepared on graduation to treat patients with such disorders. This article describes a prospective survey of graduating chief residents during the 2013-2014 academic year in which 72% of chief residents planned to pursue a fellowship. ⋯ Seventy-five percent of the responding chief residents reported that most of the residents in their program felt that the current amount of required rotations in MSK, sports, spine, or pain medicine was adequate and 85% felt comfortable practicing in a noninterventional spine or MSK position after graduation without a fellowship. The results of this survey provide an updated perspective on the current trends among graduating residents as well as how residents perceive their MSK curriculum. These results may prove useful when evaluating MSK curriculums and shaping resident education to maximize career goals.
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Am J Phys Med Rehabil · Feb 2016
Case ReportsRecovery of an Injured Cingulum via the Lateral Cholinergic Pathway in a Patient with Traumatic Brain Injury.
We report on a patient with traumatic brain injury who showed recovery of an injured cingulum via the lateral cholinergic pathway, using diffusion tensor tractography (DTT). A 63-year-old man underwent craniotomy for subarachnoid hemorrhage and subdural hemorrhage in both frontotemporal lobes, which occurred by hitting his head against a floor after falling from approximately 2 m. The Wechsler Intelligence Scale and the Seoul neuropsychological screening battery were used for evaluation of cognitive function. ⋯ On 4-week DTT, discontinuations were observed superior to the genu of the corpus callosum in both cingula. However, on 9-month DTT, the discontinued anterior part of the right cingulum was elongated inferoposteriorly through an unusual neural tract, which ran through the external capsule and the white matter of the temporo-occipital lobes. The results of this study seem to suggest a mechanism for recovery of an injured cingulum after brain injury.
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Am J Phys Med Rehabil · Jan 2016
Case ReportsUltrasound-Guided Musculocutaneous Nerve Block in Postherpetic Neuralgia.
Postherpetic neuralgia is a common and challenging complication of herpes zoster infection, particularly in older people. In recent decades, first-line treatments, including oral or topical medication, have become well established. ⋯ Symptoms remained controlled at 1 mo follow-up. Ultrasound can be readily applied to improve the accuracy and efficiency of peripheral nerve block as it is currently widely used to evaluate the musculoskeletal system in clinical settings.
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Am J Phys Med Rehabil · Jan 2016
Association Between Sagittal Balance and Scoliosis in Patients with Parkinson Disease: A Cross-sectional Study.
The aim of this study was to describe the association between scoliosis and sagittal balance parameters in Parkinson disease patients. ⋯ Pelvic parameters were similar in the two groups, whereas spinosacral angle was lower in patients with scoliosis. The prevalence of scoliosis in Parkinson disease was higher than what was previously described and the thoracolumbar spine was the mostly affected.
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Myofascial pain syndrome is a common musculoskeletal pain disorder characterized by the presence of myofascial trigger points (MTrPs). The diagnosis of myofascial pain syndrome is currently made on clinical grounds. Numerous diagnostic criteria are used to identify myofascial pain syndrome, including the localization of MTrPs. ⋯ This comprehensive review focuses on summarizing ultrasound imaging techniques that have shown promise in visually localizing the trigger point. The authors' literature search identified three sonographic approaches that have been used in MTrP localization: conventional gray-scale imaging, Doppler imaging, and elastographic ultrasound imaging. This review article explains the basic physics behind the imaging methods and summarizes the characteristics of the MTrP as identified by the ultrasonic techniques.