Current Clinical Concepts: Management of Common Lumbar Spine Posterior Column Disorders in Young, Active Individuals.

Although posterior column disorders, such as spondylolysis and spondylolisthesis, are not commonly encountered in the general population, athletic trainers frequently see these conditions in athletic and active individuals due to the repetitive spinal extension and rotational loads placed on the pars interarticularis while participating in sport. Athletic trainers can successfully evaluate patients with posterior column disorders by performing a complete and comprehensive clinical examination to identify the location of pain, test spinal stability, and recognize compensatory movement patterns. Conservative management typically leads to a successful outcome in this population, with rest, bracing, and the use of therapeutic exercise having the best supporting evidence. In this Current Clinical Concepts review, we outlined the etiology and risk factors frequently associated with disorders of the posterior column. Additionally, we synthesized the literature for common evaluation techniques and interventions associated with the posterior column and provided a proposed rehabilitation progression to use in a younger, athletic population.

Psychosis and Rectal Bleeding as the Presenting Symptoms of AIDS in an Adolescent Male.

Socioeconomic status, racial health disparities, and age are some of the many barriers that may confound and delay the diagnosis of human immunodeficiency virus (HIV). Despite the new and highly effective advancements in the treatment of HIV, in the United States, there is a disparity in the rate of timely diagnosis and treatment among Black/African Americans, men who have sex with men, those who suffer from homelessness, and transgendered youth. While there are existing recommendations in place to guide the testing of adolescents for HIV, the rate of testing is highly variable, which can lead to missed diagnoses. We present the case of a previously healthy 17-year-old African American male with psychosis who was initially diagnosed with a primary psychiatric disorder. Three weeks later, the patient presented with rectal bleeding. Further evaluation revealed that the patient was positive for HIV. The psychiatric symptoms were attributed to HIV dementia and rectal bleeding to HIV colitis. To our knowledge, this is the first case report of a patient with HIV dementia and rectal bleeding as the initial presenting symptoms of AIDS. This case demonstrated the potential consequences of variable testing practices for HIV and the devastating sequela that can follow the lack of timely diagnosis.