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Worsening Cervical Epidural Hematoma After Tissue Plasminogen Activator Administration for Stroke Like Symptoms
Conclusion. To our knowledge, only three cases of cervical SEH with hemiparesis erroneously treated with tPA resulting in neurological decline because of the enlargement of an existing hematoma, including the current case, have been reported in the English literature. It is important for physicians, especially those who administer tPA treatment, to include cervical SEH in the differential diagnosis of stroke in patients presenting with sudden back pain followed by the onset of neurological deficits including hemiparesis. Level of Evidence: 5
Source: Spine - March 26, 2016 Category: Orthopaedics Tags: Case Report Source Type: research

Musculoskeletal manifestations of Fabry disease: A retrospective study
Conclusion The diagnosis of Fabry disease is usually delayed, due to confusion with more common disorders. Musculoskeletal manifestations may constitute the presenting symptoms. Past or present pain in the extremities is typical. Osteoporosis may develop early and become severe. Together with the family history, the presence of musculoskeletal manifestations can lead to the correct diagnosis by prompting alpha-galactosidase assays in males and genetic testing in females. Fabry disease is often responsible for musculoskeletal manifestations, of which the most common are pain in the extremities and osteoporosis. These manife...
Source: Joint Bone Spine - December 15, 2015 Category: Orthopaedics Source Type: research

Using a goal attainment scale in the evaluation of outcomes in patients with diplegic cerebral palsy
Three-dimensional gait analysis is a standard evaluation of ambulant patients with cerebral palsy (CP). However, kinematic and kinetic outcomes may overlook a patient's goals and individual needs, such as pain relief. A Goal Attainment Scale (GAS) provides subjective information about a patient's needs. Goal Attainment Scales (GASs) were initially used in the 1960s in mental health [1], but have since been applied to other aspects of health care including stroke rehabilitation and geriatric care [2,3].
Source: Gait and Posture - December 14, 2015 Category: Orthopaedics Authors: D. McMorran, L.W. Robinson, G. Henderson, J. Herman, J.E. Robb, M.S. Gaston Tags: Full length Article Source Type: research

Spontaneous vertebral artery dissection: Posterior circulation stroke
Manoj Deshmukh, Anju Wadhwa, Ravi RajdeoJournal of Craniovertebral Junction and Spine 2015 6(4):206-208Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke. A 46-year-male complaining of sudden onset headache, neck pain with right-sided neuro deficit in the form of hemiparesis was evaluated by contrast magnetic resonance imaging and dual-energy computed tomography (CT) and brain neck angiography which revealed a short segment extracranial left-sided VAD, associated with acute infarct in the left occipital region. The patient was managed conservatively and f...
Source: Journal of Craniovertebral Junction and Spine - October 21, 2015 Category: Orthopaedics Authors: Manoj DeshmukhAnju WadhwaRavi Rajdeo Source Type: research

Balloonsacroplasty: C-arm or CT controlled application? : Experience with 46 patients.
CONCLUSION: Balloon sacroplasty results in a reliable and significant reduction in pain for sacral insufficiency fractures. The C-arm controlled cement application resulted in more frequent extravasation and complications than CT-guided application. PMID: 25681131 [PubMed - as supplied by publisher]
Source: Der Unfallchirurg - February 15, 2015 Category: Orthopaedics Authors: Prokop A, Andresen R, Chmielnicki M Tags: Unfallchirurg Source Type: research

Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study
Conclusions: This cohort study revealed that nearly half of the participants with baseline CWP resolved from CWP 11 years later. Among those whose CWP did not resolve, obesity, sleeping problems and chronic disease predicted CWP persistence, while aging and male sex was protective. Anxiety, mixed anxiety and depression, former smoking, and overweight were weakly associated, while depression, moderate exercise, and alcohol use were not associated with persistent CWP.
Source: BMC Musculoskeletal Disorders - June 20, 2014 Category: Orthopaedics Authors: Ingunn MundalRolf GråweJohan BjørngaardOlav LinakerEgil Fors Source Type: research

Minimally Invasive Soft Tissue Release of Foot and Ankle Contracture Secondary to Stroke
We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gai...
Source: Journal of Foot and Ankle Surgery - July 26, 2013 Category: Orthopaedics Authors: Troy J. Boffeli, Rachel C. Collier Tags: Case Reports and Series Source Type: research

A theoretical analysis of the influence of wheelchair seat position on upper extremity demand
Abstract: Background: The high physical demands placed on the upper extremity during manual wheelchair propulsion can lead to pain and overuse injuries that further reduce user independence and quality of life. Seat position is an adjustable parameter that can influence the mechanical loads placed on the upper extremity. The purpose of this study was to use a musculoskeletal model and forward dynamics simulations of wheelchair propulsion to identify the optimal seat position that minimizes various measures of upper extremity demand including muscle stress, co-contraction and metabolic cost.Methods: Forward dynamics simulat...
Source: Clinical Biomechanics - April 22, 2013 Category: Orthopaedics Authors: Jonathan S. Slowik, Richard R. Neptune Tags: Papers Source Type: research

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