Diagnostics

What Is the Predictive Value of MRI for the Occurrence of Knee Replacement Surgery in Knee Osteoarthritis?

J-P Pelletier Ann Rheum Dis. 2013;72(10):1594-1604. Abstract Knee osteoarthritis is associated with structural changes in the joint. Despite its many drawbacks, radiography is the current standard for evaluating joint structure in trials of potential disease-modifying osteoarthritis drugs. MRI is a non-invasive alternative that provides comprehensive imaging of the whole joint. Frequently used MRI measurements in […]

Accuracy of Physical Examination for Chronic Lumbar Radiculopathy

The main finding is that individual clinical index tests lack diagnostic accuracy for predicting whether a lumbar nerve root is impinged or not at a specific level in patients with chronic lumbar radiculopathy in specialised care.

An Algorithmic Approach to Mechanical Hip Pain

Lazaros A. Poultsides, MD, MSc, PhD HSS J. 2012 October; 8(3): 213–224. Published online 2012 September 21. doi:  10.1007/s11420-012-9304-x Full Text Article:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470663/ Abstract Background As our understanding of hip pathology evolves, the focus is shifting toward earlier identification of hip pathology. Therefore, it is vitally important to elucidate intra-articular versus extra-articular pathology of hip pain in every step […]

Clinical Assessment of the Shoulder – FULL TEXT ARTICLE

Thomas D Donnelly Open Orthop J. 2013; 7: 310–315. Published online 2013 September 6. doi: 10.2174/1874325001307010310 PMCID: PMC3785041 Suppl 3 Abstract The shoulder joint is complex in structure and functionality. It is often difficult to assess clinically due to the great variety of associated pathology. This article presents an overview of the anatomy of the […]

Active Hip Abduction Test as a Screening Test for Identifying Occupational Low Back Pain

Authors: Erika Nelson-Wong, DPT1, Timothy Flynn, PT, PhD2, Jack P. Callaghan, PhD3  AFFILIATIONS: 1 PhD candidate, University of Waterloo, Department of Kinesiology, Waterloo, ON, Canada.2 Associate Professor, Regis University, School of Physical Therapy, Denver, CO. 3 Associate Professor, University of Waterloo, Department of Kinesiology, Waterloo, ON, Canada. This work was conducted with financial support from the Natural Science and Engineering Research Council Canada, and […]

One-week time course of the effects of Mulligan’s Mobilisation with Movement and taping in painful shoulders

Pamela Teys Previous research suggests that Mulligan’s Mobilisation-with-Movement (MWM) technique for the shoulder produces an immediate improvement in movement and pain. The aims of this study were to investigate the time course of the effects of a single MWM technique and to ascertain the effects of adding tape following MWM in people with shoulder pain. […]

New objective findings after whiplash injuries

High blood flow in painful cervical soft tissue: An ultrasound pilot study Hatem Kalawy Scandinavian Journal of Pain Volume 4, Issue 4 , Pages 173-179, October 2013 Highlights •Painful neck regions in patients with whiplash-associated disorder were studied. •Grey scale ultrasound and colour Doppler were used to confirm high blood flow. •Whiplash patients had higher […]

Diagnostic accuracy of the clinical examination in identifying the level of herniation in patients with sciatica

Hancock MJ, et al. Spine (Phila Pa 1976). 2011 May 15;36(11):E712-9. doi: 10.1097/BRS.0b013e3181ee7f78. Affiliation Faculty of Health Sciences, University of Sydney, Australia. Abstract STUDY DESIGN: Cross sectional OBJECTIVE: To investigate the ability of the neurological examination to identify the specific level of a disc herniation in patients with sciatica and confirmed disc herniation. SUMMARY OF […]

Is MRI Monitoring of Adolescent Scoliosis Feasible Using Upright MRI?

Is Radiation-Free Diagnostic Monitoring of Adolescent Idiopathic Scoliosis Feasible Using Upright Positional Magnetic Resonance Imaging? Diefenbach, Christopher BS Spine: 01 April 2013 – Volume 38 – Issue 7 – p 576–580 Abstract Study Design. Prospective clinical trial. Objective. The purpose of this study was to determine if an upright positional magnetic resonance imaging (MRI) protocol […]

Do more MRI findings imply worse disability or more intense low back pain?

A cross-sectional study of candidates for lumbar disc prosthesis. AuthorsBerg L, et al. Show all Journal Skeletal Radiol. 2013 Nov;42(11):1593-602. doi: 10.1007/s00256-013-1700-x. Epub 2013 Aug 28. PubMed Abstract:  http://www.ncbi.nlm.nih.gov/m/pubmed/23982421/ Affiliation Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway, linda.berg@kir.uib.no. Abstract OBJECTIVE: To examine whether combined magnetic resonance imaging (MRI) findings are […]

A user’s guide to performance of the best shoulder physical examination tests

A description of clinical shoulder tests is provided with explanations on exact testing procedures and complimentary photographs.

Outcomes from MRI-confirmed symptomatic cervical disk herniation patients treated with high-velocity, low-amplitude spinal manipulative therapy

J Manipulative Physiol Ther. 2013 Oct;36(8):461-7. doi: 10.1016/j.jmpt.2013.07.002. Epub 2013 Aug 12. Peterson CK, Schmid C, Leemann S, Anklin B, Humphreys BK. Abstract OBJECTIVE: The purpose of this study was to investigate outcomes of patients with cervical radiculopathy from cervical disk herniation (CDH) who are treated with spinal manipulative therapy. METHODS: Adult Swiss patients with […]

Can pathoanatomical pathways of degeneration in lumbar motion segments be identified by clustering MRI findings

Rikke K Jensen BMC Musculoskeletal Disorders 2013, 14:198 doi:10.1186/1471-2474-14-198 Abstract Background Magnetic Resonance Imaging (MRI) is the gold standard for detailed visualisation of spinal pathological and degenerative processes, but the prevailing view is that such imaging findings have little or no clinical relevance for low back pain. This is because these findings appear to have […]

Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy

This systematic review and meta-analysis demonstrate that neurological testing procedures have limited overall diagnostic accuracy in detecting disc herniation with suspected radiculopathy.

Clinical findings and electrodiagnostic testing in 108 consecutive cases of lumbosacral radiculopathy due to herniated disc

Neurophysiol Clin. 2013 Oct;43(4):205-15. doi: 10.1016/j.neucli.2013.05.004. Epub 2013 Jun 20. Mondelli M, Aretini A, Arrigucci U, Ginanneschi F, Greco G, Sicurelli F. Abstract STUDY AIM: This prospective study aim to examine whether clinical findings and electrodiagnostic testing (EDX) in patients with lumbosacral monoradiculopathy due to herniated disc (HD) differ as a function of root involvement […]

Magnetic Resonance Imaging Predictors of Surgical Outcome in Patients With Lumbar Intervertebral Disc Herniation

Lurie, Jon D. MD, MS Spine: 15 June 2013 – Volume 38 – Issue 14 – p 1216–1225 Abstract Study Design. A retrospective cohort design. Objective. To determine whether baseline magnetic resonance imaging findings, including central/foraminal stenosis, Modic change, disc morphology, facet arthropathy, disc degeneration, nerve root impingement, and thecal sac compression, are associated with […]

Immediate effects of spinal manipulative therapy on regional antinociceptive effects in myofascial tissues in healthy young adults

Srbely JZ J Manipulative Physiol Ther. 2013 Jul-Aug;36(6):333-41. doi: 10.1016/j.jmpt.2013.01.005. Epub 2013 Jul 3. Abstract OBJECTIVE: The purpose of this study was to investigate if spinal manipulative therapy (SMT) can evoke immediate regional antinociceptive effects in myofascial tissues by increasing pressure pain thresholds (PPTs) over myofascial trigger points in healthy young adults. METHODS: A total […]

Spinal manipulation vs image guided lumbar nerve root injections for lumbar disc herniation

J Manipulative Physiol Ther. 2013 May;36(4):218-25. doi: 10.1016/j.jmpt.2013.04.005. Epub 2013 May 22. Symptomatic magnetic resonance imaging-confirmed lumbar disk herniation patients: a comparative effectiveness prospective observational study of 2 age- and sex-matched cohorts treated with either high-velocity, low-amplitude spinal manipulative therapy or imaging-guided lumbar nerve root injections. Peterson CK, Leemann S, Lechmann M, Pfirrmann CW, Hodler […]

Supine MRI Cobb Measurements for Idiopathic Scoliosis Are Linearly Related to Measurements From Standing Plain Radiographs

Lee, Mark C. MD Spine: 15 May 2013 – Volume 38 – Issue 11 – p E656–E661 doi: 10.1097/BRS.0b013e31828d255d Diagnostics Abstract Study Design. Retrospective. Objective. To demonstrate a relationship between adolescent idiopathic scoliosis Cobb angle measurements obtained with standing plain radiographs and standard supine magnetic resonance (MR) images. Summary of Background Data. Patients with adolescent […]

MTHFR Gene Mutation-What’s the Big Deal About Methylation?

by Jill Carnahan, MD on May 12, 2013 UPDATE POST OF MTHFR BLOG Do you have a genetic defect in the MTHFR gene?? Maybe you’ve have a family history of heart attack or stroke… maybe you’ve suffered through multiple miscarriages. Or maybe you struggle with chronic migraine headaches or irritible bowel syndrome or depression. Perhaps […]