Physical medicine and rehabilitation clinics of North America
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Little injury data exists for children who have disabilities. There is an urgent need to address injury prevention and to improve safety standards for this group. Understanding the epidemiology of injuries will allow clinicians to accurately advise patients and their families on individual risks and counsel them in steps to take to reduce those risks. ⋯ Hospitals must have Child Protective Services teams with specific training in abuse to children with disabilities. Discussion of maltreatment risk should be addressed during routine office visits and appropriate resources should be made available to provide support to families. Educational programs should be developed to alert providers to the risks of abuse of children who have disabilities.
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This article reviews the current understanding of pain evaluation as applied to children who have chronic illness and disabilities. Utilizing a collaborative medical approach, psychiatric principles of management are discussed. Case scenarios are presented to outline application of general strategies of clinical management.
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Phys Med Rehabil Clin N Am · Aug 2002
ReviewLumbar spinal stenosis, cauda equina syndrome, and multiple lumbosacral radiculopathies.
Narrowing of the vertebral canal, the lateral recess, or the neural foramina causes lumbar spinal stenosis. Stenosis results from degenerative changes that usually are superimposed on a congenitally narrowed spinal canal and can result in significant pain and disability, especially in the elderly. Signs and symptoms are related to the compression of neural and vascular elements from the limited canal space. The article reviews the anatomy and pathophysiology, clinical syndrome, diagnostic workup, and natural history of lumbar spinal stenosis to aid in proper diagnosis and treatment.
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Advances in imaging have greatly improved the ability to display spine anatomy and pathology. This article describes the imaging findings in degenerative, traumatic, infectious, and neoplastic disease. Anatomic information, however, must be tempered by an understanding of asymptomatic disease and interpreted in the context of the clinical syndrome.
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Phys Med Rehabil Clin N Am · Aug 2002
ReviewElectrodiagnostic approach to patients with suspected radiculopathy.
This article reviews the electrodiagnostic testing for persons suspected of having radiculopathies and the expected sensitivities that different testing modalities provide. One cannot minimize the importance of the clinical evaluation and differential diagnosis formulation by the electrodiagnostician to guide testing. ⋯ Electromyographic screening examinations using six muscles are possible that optimize identification yet minimize patient discomfort. Electrodiagnostic findings must be interpreted relative to the patient's clinical presentation, and the consultant should tailor the electrodiagnostic study to the clinical situation.