Adding an ultrasound scan before the injection reveals a rare cause of meralgia paresthetica: inguinal lymphadenomegaly No abstract available

Nocebo Effects in Concussion: Is All That is Told Beneficial? Nocebo effects refer to new or worsening symptoms that develop in response to negative health-related information, beliefs, and/or experiences. In recent years, research on concussion pathophysiology has significantly advanced. Through health campaigns and media coverage, emerging knowledge on the risks of this injury has been quickly disseminated to the public, and nowadays the public perceives concussions as more hazardous to health than ever before. While advancements in concussion-related research and care are of great importance and value, we ask in this article whether the increasing negative publicity regarding concussion also carries any latent costs. Are additional nocebo effects being fostered? To do so, we will review the literature on the psychological and neurobiological processes underlying nocebo effects, present a series of clinical studies demonstrating the ways in which nocebos may impact concussion outcomes both clinically and societally, then speculate on further potential mechanisms for nocebo effects in concussion. We conclude with an outline of the specific efforts one may take to minimize nocebo effects in concussion-related care. Author Disclosures: No financial disclosures or competing interests exist. This manuscript was not supported by any funding or grants. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Intra-articular Sacroiliac Joint Needle Placement: Ultrasound, Fluoroscopy, and the Criterion Standard No abstract available

Ultrasound Guided Sacroiliac Joint Injections No abstract available

Clinical Findings and Electrodiagnostic Testing in Ulnar Neuropathy at the Elbow and Differences According to Site and Type of Nerve Damage Objective To evaluate the clinical and electrodiagnostic testing (EDX) in ulnar neuropathy at the elbow (UNE) and differences according to site (humeroulnar arcade, HUA, vs. retroepicondylar groove, REG) and injury physiopathology (axonal vs. demyelinating), through prospective multicenter case-control study. Design Cases and controls were matched by age and sex. UNE diagnosis was made on symptoms. Statistical analysis was performed using Mann-Whitney, Chi-square and ANOVA tests. Results 144 cases and 144 controls were enrolled. Sensory loss in the fifth finger (U5) had the highest sensitivity (70.8%) compared to clinical findings. Motor conduction velocity across-elbow (MCV-AE) reached the highest sensitivity (84.7%) in localizing UNE recording from at least one of two hand muscles (first interosseous-FDI and abductor digit minimi-ADM). Abnormal sensory action potential amplitude from U5 occurred more frequently in axonal than in demyelinating forms. Differences between REG and HUA regarded conduction block (CB) and job type. Conclusions Clinical findings have less usefulness than EDX in UNE diagnosis. MCV-AE recorded from both ADM and FDI increases diagnostic accuracy. Axonal forms have greater clinical and EDX severity than demyelinating forms, that are more frequent in REG. Manual workers prevailed in HUA. These findings may be helpful in prognostic and therapeutic approaches. Disclosures: The authors state that there are no conflicts of interest and that they have not received any financial support. This research has never been presented previously as a full manuscript, nor as an abstract for scientific congresses. Correspondence: Dr. Claudia Vinciguerra, MD, Department of Medicine, Surgical and Neurological Sciences, University of Siena. Viale Bracci 2, 53100 Siena, Italy, Phone: +39-0577-235808, Fax: +39-0577-233411. E-mail: claudiavinci@hotmail.it What is known: Electrodiagnostic testing (EDX) compared to clinical findings, remains the most sensitive tool for the diagnosis of Ulnar Neuropathy at the Elbow (UNE). What is new: Delayed Motor Conduction Velocity (MCV)-across-elbow achieves higher sensitivity in localizing UNE than MCV drop and increases the diagnostic accuracy when recorded from both abductor digiti minimi (ADM) and first dorsal interosseous (FDI). Identifying both the site and physiopathology of injury, can be useful for prognosis and treatment of UNE. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Prevalence and Anatomical Distribution of Bone Stress Injuries in the Elite Para Athlete Bone stress injury (BSI) is a common overuse injury in athletes. Risk factors for BSI in athletes include the Female Athlete Triad (Triad); this has not been evaluated in para athletes. The purpose of this study is to identify risk factors, prevalence and anatomical distribution of BSI in para athletes. A cross-sectional online survey on health characteristics and prior fractures including BSI was completed by para athletes training for the 2016 or 2018 Paralympic Games. 260 para athletes completed the survey (659 invited, response rate 40%). Half reported prior fracture, and BSI was reported in 9.2% of all athletes. Twenty-four athletes (11 men and 13 women) sustained ≥1 BSI, including 13 athletes with two BSIs. No risk factors of the Triad, disability type or duration of disability were associated with BSI. Injuries were most common in the metatarsals (n=8) and hand/wrist (n=7). In an elite para athlete population, locations for BSI included both the upper and lower extremities. Clinically, para athletes presenting with pain localized to bone require further workup to evaluate for BSI particularly for pain in both upper and lower extremities. Further research is required to identify risk factors for BSI in para athletes. Disclosure/Funding: Authors have no conflicts of interest to disclose related to this work. No funding was received to support this investigation. Adam S. Tenforde, 1575 Cambridge Street, Cambridge, MA 02138. atenforde@partners.org. Fax: 617-952-6836 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Painful Myoclonus Triggered By Lateral Antebrachial Cutaneous Nerve Entrapment at Brachioradialis Muscle: A Case Report Compression of the lateral antebrachial cutaneous nerve (LACN) is a rare clinical entrapment syndrome often overlooked as an initial etiology of pain 1. We present a case of an episodic upper extremity painful movement disorder (myoclonus) in a 16 year old female with a remote history of a surgically stabilized supracondylar humeral fracture who was later found to have entrapment of the LACN. The incidence of a painful myoclonus triggered by a peripheral nerve entrapment is unknown 1. Combining a history and physical examination, electromyography, nerve conduction studies and ultrasound enabled us to make an accurate diagnosis that was confirmed by resolution of symptoms after surgical release. This study conforms to all CARE guidelines and reports the required information accordingly (see Supplemental Check list, Supplemental Digital Content 1, http://links.lww.com/PHM/A855). Correspondence: Heidi Prather, DO, Department of Orthopaedic Surgery, 14532 South Outer Forty Road, Chesterfield, MO 63017, Phone: 3145143544. Email: pratherh@wustl.edu Authors Disclosures: None No funding was received for this research Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

The Use of Ultrasonography in Expediting Septic Joint Identification and Treatment: A Case Report No abstract available

Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: Is platelet rich plasma injection more effective than corticosteroid for treatment of gluteal tendinopathy? No abstract available

An Uncommon Cause of Lateral Hip Pain After Multi-Trauma: A Clinical Vignette No abstract available