{"title":"Unique Cause of Chronic Right Hip Pain and Unilateral Leg Swelling 10 Yrs Following Total Hip Arthroplasty.","authors":"Evan Banks, Mahmood Gharib","doi":"10.1097/PHM.0000000000002662","DOIUrl":"10.1097/PHM.0000000000002662","url":null,"abstract":"<p><strong>Abstract: </strong>Patient is a 64-yr-old female with a history of right total hip arthroplasty who presented with progressive, painful right lower extremity edema and chronic groin pain for 2 years. A computed tomography scan from October 2021 revealed an expanding, large iliopsoas bursal fluid collection that caused compression of the right common femoral artery and vein in June 2023. Further workup excluded deep venous thrombosis or infectious causes. Iliopsoas fluid collections can result from various conditions such as a rare complication of total hip arthroplasty. This is likely due to mechanical irritation from the prosthetic components and was confirmed with resolution of symptoms after undergoing revision of total hip arthroplasty in 2024. This case highlights iliopsoas hematoma as a rare but important consideration in patients with unilateral lower extremity edema after total hip arthroplasty.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e110-e112"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"X-ray Prediction of Magnetic Resonance Imaging in Low Back Pain.","authors":"Robert J McCormick, Michael D Perloff","doi":"10.1097/PHM.0000000000002741","DOIUrl":"10.1097/PHM.0000000000002741","url":null,"abstract":"<p><strong>Abstract: </strong>Magnetic resonance imaging use in low back pain management can be associated with added costs and increased surgical interventions. Lumbar x-ray findings predicting magnetic resonance imaging results were assessed in patients with low back pain, excluding postsurgical, red flag, or spinal stenosis history. At an outpatient pain clinic, 100 patients were selected (sequentially) from 12/1/2021 to 3/15/2022 that had lumbar x-rays within 1 yr prior to lumbar magnetic resonance imaging. X-ray and magnetic resonance imaging reports were analyzed by two readers. Forty-six patients had moderate facet hypertrophy on x-ray, 35 (76.1%) also had moderate facet hypertrophy on magnetic resonance imaging (Spearman's rank correlation Rs = 0.386, P < 0.0001). Thirty-eight patients had moderate multilevel degenerative changes on x-ray, 34 (89.5%) also had moderate disc bulge on magnetic resonance imaging (Spearman's Rs = 0.360, P < 0.001). Eighteen patients who had moderate disc height loss on x-ray, 14 (77.8%) also had moderate disc desiccation, height loss, or space narrowing on magnetic resonance imaging (Spearman's Rs = 0.554, P < 0.00000001). Forty-three patients had a listhesis on x-ray, and 20 (46.5%) also had a listhesis on magnetic resonance imaging (Spearman's Rs = 0.458, P < 0.0001). Lumbar x-ray is a reasonable study in the setting of axial and subacute radicular low back pain, where red flags are absent, predicting moderate pathology on magnetic resonance imaging > 75% of the time, and being more sensitive for listhesis.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"671-674"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nuran Eyvaz, Sevda Adar, Ali İzzet Akçin, Ümit Dündar, Hasan Toktaş, Selma Eroğlu
{"title":"Comparison of Ultrasound-Guided Hydrodissection With Various Volumes of 5% Dextrose for Carpal Tunnel Syndrome: A Prospective Randomized Controlled Double-Blind Trial.","authors":"Nuran Eyvaz, Sevda Adar, Ali İzzet Akçin, Ümit Dündar, Hasan Toktaş, Selma Eroğlu","doi":"10.1097/PHM.0000000000002675","DOIUrl":"10.1097/PHM.0000000000002675","url":null,"abstract":"<p><strong>Objective: </strong>Ideal volume of 5% dextrose for median nerve hydrodissection for treating carpal tunnel syndrome is still unknown. This study assessed the efficacy of nerve hydrodissection using varying volumes of 5% dextrose for treating mild to moderate carpal tunnel syndrome.</p><p><strong>Design: </strong>Eighty participants with unilateral mild to moderate carpal tunnel syndrome were randomized into groups to receive either 5 ml of normal saline, 5 ml of 5% dextrose, 10 ml of normal saline, and 10 ml of 5% dextrose, with each group undergoing one session of ultrasound-guided hydrodissection. Visual analog scale, Boston Carpal Tunnel Syndrome Questionnaire, grip and pinch strength, cross-sectional area of median nerve, and electrophysiological assessment were performed at baseline and weeks 4 and 12.</p><p><strong>Results: </strong>In the 10 ml 5% dextrose group, visual analog scale scores considerably improved compared with those in the normal saline groups. Although nerve cross-sectional area values decreased in all groups during follow-ups, the 10 ml 5% dextrose group showed a statistically significant improvement compared to the normal saline groups by the 12th week ( P ≤ 0.01).</p><p><strong>Conclusions: </strong>Ultrasound-guided median nerve hydrodissection with 10 ml 5% dextrose was more effective in reducing pain and nerve size than the normal saline groups at the 12th week.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"596-604"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alpaslan Fatih Kaynar, Beytullah Yazar, Abdullah Emre Uğur, Walter R Frontera, Levent Özçakar
{"title":"Recommendations/Guidelines for Osteoarthritis: Where Do the Physiatrists Stand and What About Ultrasound?","authors":"Alpaslan Fatih Kaynar, Beytullah Yazar, Abdullah Emre Uğur, Walter R Frontera, Levent Özçakar","doi":"10.1097/PHM.0000000000002757","DOIUrl":"10.1097/PHM.0000000000002757","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"593-595"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Austin Shokraeifard, Aditya Raghunandan, T Tyler Patterson
{"title":"When Back Pain Isn't Just Back Pain: A Case of Spinal Infection Without Persistent Systemic Signs.","authors":"Austin Shokraeifard, Aditya Raghunandan, T Tyler Patterson","doi":"10.1097/PHM.0000000000002794","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002794","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael B Furman, Gene Tekmyster, Lelia Gilhool, Jesse S Bernstein, Ajay R Kurup, Christopher T Bednarek, Holden M Caplan, Byron Schneider
{"title":"Epidural Hematoma Risks Associated with Ceasing Vs Maintaining Anticoagulant And/or Antiplatelet Medications For Spine Facet Interventions.","authors":"Michael B Furman, Gene Tekmyster, Lelia Gilhool, Jesse S Bernstein, Ajay R Kurup, Christopher T Bednarek, Holden M Caplan, Byron Schneider","doi":"10.1097/PHM.0000000000002795","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002795","url":null,"abstract":"<p><strong>Background: </strong>Facet joint interventions are commonly performed procedures in patients with neck and back pain, including patients managed with anticoagulant/antiplatelet medications (ACAP). Temporary cessation of ACAP medications may increase the risk of thromboembolic complications, which may be unnecessary.</p><p><strong>Objectives: </strong>Determine the risk of clinically relevant hemorrhagic complications in patients undergoing facet interventions.</p><p><strong>Methods: </strong>Consecutive patients from September 19, 2009-Jun 16, 2017, who were on ACAP medications and scheduled for an any facet intervention in the cervical, thoracic and lumbosacral spine were retrospectively audited for bleeding complications for a minimum of 90 days post-procedure.</p><p><strong>Results: </strong>582 procedures targeting the cervical, thoracic, or lumbosacral facet joints were performed on patients on AC or AP medications. 128 patients ceased their ACAP medication prior to the procedure and 454 maintained ACAP medication. No clinically relevant epidural hematomas (EH) were noted in the patient cohort (0/582, 0%, 95% CI 0.0-0.6%).</p><p><strong>Discussion/conclusions: </strong>The risk of clinically relevant bleeding complications including epidural hematoma in properly performed facet interventions is low. This information is crucial in being able to quantitatively determine the risk of ceasing or maintaining ACAP medications prior to cervical thoracic and lumbar facet interventions.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenna Kwiecinski, Ashley Amundson, Corinna Franklin, Rey Ramirez, Michael Saulino
{"title":"A Comparative Analysis of Women's Experiences in Physical Medicine and Rehabilitation versus Orthopaedic Surgery.","authors":"Jenna Kwiecinski, Ashley Amundson, Corinna Franklin, Rey Ramirez, Michael Saulino","doi":"10.1097/PHM.0000000000002768","DOIUrl":"10.1097/PHM.0000000000002768","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to understand positive and negative experiences shared between women in PM&R and orthopaedic surgery to uncover pervasive issues within two male-dominated specialties with the end goal of improving both interest and representation of women.</p><p><strong>Design: </strong>Surveys were distributed to women practicing PM&R and to women practicing orthopaedic surgery. Questions included close-ended, open-ended, and identifiers on a 4-point modified Likert scale. Data was anonymously collected using REDCap electronic data capture tools.</p><p><strong>Results: </strong>Negative experiences were much more common within orthopaedics, which also has a lower percentage of women. 7.3% of PM&R respondents versus 28.2% of orthopaedics respondents reported experiencing sexual harassment. 11.5% of PM&R respondents versus 79.2% of orthopaedics respondents reported witnessing sexist comments or behaviors. Furthermore, 13.7% of PM&R respondents versus 60.6% of orthopaedics respondents reported an unwelcoming environment. Regarding positive experiences, 68.6% of PM&R respondents versus 71.6% of orthopaedics respondents found exposure to the field encouraging. 69.6% of PM&R respondents versus 87.4% of orthopaedics respondents reported having a mentor in the field encouraging.</p><p><strong>Conclusion: </strong>Stark differences were reported regarding sexist comments or behaviors, illustrating a dichotomous environment between PM&R and orthopaedic surgery. Although PM&R has significantly lower percentages of these behaviors, there is still ample room for improvement.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is Ultrasound-Guided Steroid Injection Less Effective in Carpal Tunnel Syndrome Patients with Bifid Median Nerve?: A Focus on Short-Term Efficacy.","authors":"Büşra Şirin Ahisha, Nurdan Paker","doi":"10.1097/PHM.0000000000002771","DOIUrl":"10.1097/PHM.0000000000002771","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of bifid median nerve (BMN) on treatment response to ultrasound-guided corticosteroid injection in patients with carpal tunnel syndrome (CTS).</p><p><strong>Design: </strong>This observational study included 50 patients with mild to moderate CTS undergoing ultrasound-guided corticosteroid injection. During the procedure, 25 patients with a BMN and 25 with a normal median nerve (NMN) were consecutively selected. 21 from each group completed the 4-week follow-up. Symptom severity, functional status, and disability were assessed using the Visual Analog Scale (VAS), the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), and the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick-DASH). Treatment response was defined as a ≥ 50% reduction in VAS at 4 weeks post-injection.</p><p><strong>Results: </strong>Pre-treatment VAS, BCTQ-SSS, BCTQ-FSS, and Quick-DASH scores did not differ between groups (p > 0.05). At 4 weeks, 76.19% of NMN patients achieved a ≥ 50% VAS reduction versus 33.33% in the BMN group (p = 0.005). While both groups improved post-injection (p < 0.05), the BMN group showed significantly lower improvement in VAS (p = 0.004), BCTQ-SSS (p = 0.015), BCTQ-FSS (p = 0.008), and Quick-DASH (p = 0.013).</p><p><strong>Conclusions: </strong>Ultrasound-guided corticosteroid injection was effective in both groups, but response was significantly lower in BMN patients. BMN may be a risk factor for treatment failure, highlighting the need for alternative injection strategies or combination therapies to optimize outcomes.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Torrance Wang, Megan Nosek, Candace Rebuck, Gwendolyn Svehlak, Peter Gorman
{"title":"A Unique Interdisciplinary Approach to the Rehabilitation of Two Spouses Involved in Concurrent Trauma: A Case Report.","authors":"Torrance Wang, Megan Nosek, Candace Rebuck, Gwendolyn Svehlak, Peter Gorman","doi":"10.1097/PHM.0000000000002767","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002767","url":null,"abstract":"<p><strong>Abstract: </strong>A married couple presented to our acute inpatient rehabilitation unit after involvement in a motorcycle accident. The 32-year-old male sustained a traumatic spinal cord injury (i.e., T5 ASIA impairment scale B paraplegia), and the 29-year-old female suffered a traumatic brain injury resulting in left spastic hemiplegia, increased emotional lability, and cognitive deficits. To facilitate the concurrent rehabilitation of the couple, our spinal cord and brain injury rehabilitation teams worked together to create a joint rehabilitation program for optimal recovery. This included co-habitation in a shared hospital room, combined therapy sessions, and joint family meetings. By coordinating their care, our rehabilitation team was able to better prepare the patients for the collective challenges they would face upon returning home. This allowed for increased awareness of each other's limitations as well as opportunity to support and encourage one another. The model also led to reportedly decreased anxiety, increased participation in therapy, improved safety compliance, and more opportunities for family training. In the rehabilitation of family members with concurrent injuries, it is important to acknowledge the increased psychosocial challenges and discharge barriers. Rehabilitation teams should aim to coordinate care during inpatient rehabilitation to maximize emotional well-being and functional outcomes at time of discharge.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}