Physical medicine and rehabilitation clinics of North America
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Most knee structures can be accurately targeted using ultrasound guidance. These structures are usually superficial, and the overlying soft tissues are mobile and compressible, facilitating excellent visualization with a high-frequency linear array transducer. ⋯ Studies of ultrasonography-guided knee procedures have consistently shown high accuracy, and its use is particularly beneficial for obese patients, diagnostic injection specificity, safety, and precise targeting of pathology. More studies are needed to assess the clinical efficacy and cost-effectiveness of ultrasonography-guided knee procedures.
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Concussion associated with sport is a common occurrence with an estimated 1.6 to 3.8 million sports-related concussions yearly in the United States. The sideline assessment of concussion focuses on four areas: cognitive ability, balance, associated symptoms, and visual tracking. ⋯ Some of these tools are validated and reliable and some are developing and have yet to be proven to be sensitive enough for routine use. These tools along with a thorough history and physical examination enable a sideline physician to accurately diagnose concussion.
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In this review, we discuss the literature regarding both concussion and mild traumatic brain injury. We focus on the role for neuroimaging in the concussed patient and describe the recommended practices related to imaging in concussion. This discussion first focuses on the exclusion of severe injuries and is followed by a discussion of the potential utility of various advanced imaging techniques in research and clinical practice.
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Injuries to the hip and pelvis among runners can be among the most challenging to treat. Advances in the understanding of running biomechanics as it pertains to the lumbopelvic and hip regions have improved the management of these conditions. Conservative management with an emphasis on activity modification and neuromuscular exercises should comprise the initial plan of care, with injection therapies used in a supportive manner.
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Foot and ankle injuries account for nearly one-third of running injuries. Achilles tendinopathy, plantar fasciopathy, and ankle sprains are 3 of the most common types of injuries sustained during training. Other common injuries include other tendinopathies of the foot and ankle, bone stress injuries, nerve conditions including neuromas, and joint disease including osteoarthritis. This review provides an evidence-based framework for the evaluation and optimal management of these conditions to ensure safe return to running participation and reduce risk for future injury.