American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2014
Case ReportsGanglion cyst at the fibular head causing common peroneal neuropathy diagnosed with ultrasound and electrodiagnostic examination: a case report.
The common peroneal nerve is a major source of innervation to the lower limb, but it is sometimes compressed or entrapped at the fibular head. The authors present what they believe is the first reported case where peroneal nerve impingement caused by ganglion cyst compression of the nerve at the fibular head was diagnosed using a combination of ultrasound imaging and electrodiagnostic studies. The authors described the history, physical examination, electrodiagnostic findings, and musculoskeletal ultrasound findings of a patient with a left foot drop caused by a ganglion cyst compressing the common peroneal nerve at the fibular head. The increasing role of ultrasound imaging to evaluate musculoskeletal pathology is discussed.
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Am J Phys Med Rehabil · Aug 2014
A description of neck motor performance, neck pain, fatigue, and mental effort while driving in a sample with chronic whiplash-associated disorders.
Individuals with chronic whiplash-associated disorders (WADs) often note driving as a difficult task. This study's aims were to (1) compare, while driving, neck motor performance, mental effort, and fatigue in individuals with chronic WAD against healthy controls and (2) investigate the relationships of these variables and neck pain to self-reported driving difficulty in the WAD group. ⋯ Individuals with chronic WAD do not seem to have impaired neck motor performance while driving yet use greater mental effort. Neck pain, fatigue, and maximum head rotation velocity could be potential contributors to self-reported driving difficulty in this group.
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Am J Phys Med Rehabil · Aug 2014
Interventional pain management skills competency in pain medicine fellows: a method for development and assessment.
The purposes of this project were to propose an educational module to instruct pain medicine fellows in the appropriate performance of interventional pain management techniques and to verify procedural competency through objective evaluation methodology. Eight board-certified pain medicine physicians spanning two fellowship programs trained seven fellows using a standardized competency-based module. Assessment tools address the basic competencies outlined by the Accreditation Council for Graduate Medical Education (American Board of Anesthesiology Pain Medicine Content Outline). ⋯ Support for the assessment module is demonstrated by appropriate performance of interventional procedures, with improvement noted from 3-mo to 9-mo testing, successful completion of chart-stimulated oral examinations, proper performance of relevant physical examination maneuvers, and completion of program-specific medical knowledge written tests. The fellows were evaluated via patient surveys and 360-degree global rating scales, maintained procedure logs, and completed two patient-care reports; these were reviewed by program directors to ensure adequate completion. The standardized educational module and evaluation methodology presented provide a potential framework for the definition of baseline competency in the clinical skill area of interventional pain management.
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Am J Phys Med Rehabil · Jul 2014
Case ReportsCommon peroneal nerve palsy caused by compression stockings after surgery.
Peroneal nerve palsy is one of the more common entrapment neuropathies of the lower limb and can be a result of a multitude of causes. Compression stockings are commonly used for prophylaxis of deep venous thromboembolism after surgery. The entrapment on the head and the neck of the fibula caused by compression stockings is uncommon. ⋯ He had left foot drop and difficulty in walking during gait assessment. The needle electromyography confirmed total axonal degeneration of the left peroneal nerve with denervation potentials. The aim of this report was to emphasize the importance of the size and length of the compression stockings and regular skin control in avoiding the risk for peroneal nerve palsy.