ABSTRACT
This is a case of a 19-year-old female collegiate field hockey player with left leg pain, numbness, and tingling. A comprehensive workup including dynamic ultrasound, magnetic resonance imaging (MRI), and magnetic resonance angiogram (MRA) revealed a type VI functional popliteal artery entrapment syndrome (PAES). There are many options for treatment of functional PAES including activity modification, botulinum toxin injection, and surgery. To the authors' knowledge there is no published return to sport recommendation for postsurgical functional PAES. This report highlights alternative treatment options and proposes a postsurgical return to play rehabilitation protocol in functional PAES. LEVEL OF EVIDENCE: V.
Subject(s)
Arterial Occlusive Diseases/surgery , Popliteal Artery/surgery , Return to Sport , Arterial Occlusive Diseases/diagnostic imaging , Female , Humans , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Muscle, Skeletal/surgery , Paresthesia/etiology , Physical Therapy Modalities , Popliteal Artery/diagnostic imaging , Postoperative Care , Young AdultABSTRACT
This is a case of a 40-year-old female endurance athlete with right leg pain while running. A comprehensive workup revealed a fascial defect with soleus muscle herniation. Although historically in many practice settings magnetic resonance imaging is the diagnostic imaging modality of choice for suspected muscle herniation through the fascia, the use of ultrasound is increasing because of lower cost, ease of access, and dynamic evaluation. To the authors' knowledge, there has not been a direct comparison between the accuracy of magnetic resonance imaging versus ultrasound in determining the size or location of a soleus muscle herniation. LEVEL OF EVIDENCE: Not applicable.
Subject(s)
Athletic Injuries/diagnostic imaging , Magnetic Resonance Imaging/methods , Muscle, Skeletal/injuries , Running/injuries , Ultrasonography, Doppler/methods , Adult , Athletic Injuries/therapy , Conservative Treatment/methods , Female , Hernia/diagnostic imaging , Hernia/therapy , Humans , Injury Severity Score , Muscle, Skeletal/diagnostic imaging , Return to Sport , Risk Assessment , Treatment OutcomeABSTRACT
This study was intended to determine if there is variation among physiatrists in referral preferences for postacute rehabilitation for stroke patients based on physician demographic characteristics or geography.A cross-sectional survey study was developed with 5 fictional case vignettes that included information about medical, social, and functional domains. Eighty-six physiatrist residents, fellows, and attendings were asked to select the most appropriate postacute rehabilitation setting and also to rank, by importance, 15 factors influencing the referral decision. Chi-square bivariate analysis was used to analyze the data.Eighty-six surveys were collected over a 3-day period. Bivariate analysis (using chi-square) showed no statistically significant relationship between any of the demographic variables and poststroke rehabilitation preference for any of the cases. The prognosis for functional outcome and quality of postacute facility had the highest mean influence ratings (8.63 and 8.31, respectively), whereas location of postacute facility and insurance had the lowest mean influence ratings (5.74 and 5.76, respectively).Physiatrists' referral preferences did not vary with any identified practitioner variables or geographic region; referral preferences only varied significantly by case.
