Treatment of Myositis Ossificans with acetic acid phonophoresis: a case series.

OBJECTIVE: To create awareness of myositis ossificans (MO) as a potential complication of muscle contusion by presenting its clinical presentation and diagnostic features. An effective method of treatment is offered for those patients who develop traumatic MO. MANAGEMENT: Patients in this case series developed traumatic MO, confirmed on diagnostic ultrasound. Patients participated in a treatment regimen consisting of phonophoresis of acetic acid with ultrasound. OUTCOME: In all cases, a trial of phonophoresis therapy significantly decreased patient signs, symptoms and the size of the calcification on diagnostic ultrasound in most at a 4-week post diagnosis mark. DISCUSSION: Due to the potential damage to the muscle and its function, that surgical excision carries; safe effective methods of conservative treatment for MO are crucial. MO deserves more attention in the literature due to its common presentation in athletes.

OBJECTIF: Sensibilisation à la myosite ossifiante (MO) comme complication possible de contusions musculaires grâce à la présentation de son tableau clinique et de ses symptômes. Une méthode efficace de traitement est offerte pour les patients qui sont atteints de myosite ossifiante traumatique. TRAITEMENT: Les patients de cette série de cas souffrent de myosite ossifiante traumatique, confirmée par échographie. Les patients ont participé à un régime de traitement consistant en une irrigation d'acide acétique par phonophorèse. RÉSULTATS: Dans tous les cas, un essai de traitement par phonophorèse a diminué considérablement les signes et les symptômes des patients ainsi que la taille de la calcification détectée par échographie dans la plupart des cas 4 semaines après le diagnostic. DISCUSSION: En raison de la lésion possible au muscle et des dommages potentiels à sa fonction posés par l'excision chirurgicale, il est essentiel d'adopter une approche sécuritaire et efficace de traitement conservateur de la myosite ossifiante. La myosite ossifiante mérite plus d'attention dans les revues scientifiques en raison de sa fréquence chez les athlètes.

Review of methods used by chiropractors to determine the site for applying manipulation.

BACKGROUND: With the development of increasing evidence for the use of manipulation in the management of musculoskeletal conditions, there is growing interest in identifying the appropriate indications for care. Recently, attempts have been made to develop clinical prediction rules, however the validity of these clinical prediction rules remains unclear and their impact on care delivery has yet to be established. The current study was designed to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation. METHODS: Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives, to identify studies of the diagnostic reliability and validity of common methods used to identify the site of treatment application. To be included, studies were to present original data from studies of human subjects and be designed to address the region or location of care delivery. Only English language manuscripts from peer-reviewed journals were included. The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate. Data were extracted and synthesized, and were evaluated in terms of strength of evidence and the degree to which the evidence was favourable for clinical use of the method under investigation. RESULTS: A total of 2594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favoured clinical application of the diagnostic methods reviewed. The most convincing favourable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region. There was also high quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality. Evidence of mixed quality supported the use, with limitations, of postural evaluation. The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays. The evidence was of mixed quality, but unfavourable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement. CONCLUSIONS: A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favourable to strongly unfavourable in regard to using these methods. In general, the stronger and more favourable evidence is for those procedures which take a direct measure of the presumptive site of care- methods involving pain provocation upon palpation or localized tissue examination. Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine-such as skin conductance or thermography-tend not to be supported by the available evidence.

Cheerleading injuries: A narrative review of the literature.

BACKGROUND: With its increase in participation rate and complex stunts and gymnastic-like maneuvers, cheerleading injuries are on the rise. OBJECTIVE: A structured narrative review of the literature was performed to discover the status of the literature on a growing yet under recognized sport. Cheerleading injuries are described in terms of distribution, etiology, and prevention. METHODS: A literature search was conducted. The articles were then reviewed and included based on broad criteria set out by the author. RESULTS: The search produced 87 articles related to cheerleading injuries or articles with a mention of cheerleading. A total of 26 articles were included in this review based on the inclusion criteria. The most common injury experienced by a cheerleader is an ankle ligament sprain. SUMMARY: The recognition of cheerleading as a sport and a mandatory reporting database are needed along with further research for injury prevention strategies to be implemented.