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ABDOMINAL WALL ENDOMETRIOSIS: Lower rectus abdominis Intramuscular mass, immediately, deep to c-section scar. Young cross fitter came in to r/o muscle injury with non cyclic pain (which is a frequent presentation in spite of being ectopic endometrial tissue) #msk #ultrasound #sportsimaging

13,760 просмотров • 9 месяцев назад •via X (Twitter)

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Abdominal wall pain: differential diagnosis A 28-year-old soccer player presented with right periumbilical pain of 2 months' duration. An MRI was performed, which showed no abnormalities in the abdominal wall. He was diagnosed with anterior cutaneous nerve entrapment syndrome (ACNES), and perineural injection was performed, with no improvement in symptoms. He came to the clinic for a second opinion, presenting with tenderness on palpation of the middle third of the rectus abdominis muscle, which increased with trunk resistance flexion. The pain decreased after this test was performed after muscle inhibition. An ultrasound assessment was completed, revealing no abnormalities in the discomfort, but evidence of increased thickness and decreased echogenicity of the tendon at its origin in the pubic ramus, associated with significant pain on sonopalpation, related to tendinosis. An evaluation was completed with a thoracic spine examination, revealing significant pain at the level of the spinous process of T8 (the rectus abdominis muscle is innervated by the T7-T12 thoracoabdominal nerves). It was decided to treat the patient with ultrasound-guided injections around the rectus abdominis tendon with 1 cc of triamcinolone and 1 cc of 2% lidocaine, and periradicular injections of the right T8 muscle with 2 cc of betamethasone and 1 cc of 2% lidocaine. The symptoms resolved immediately, and the patient did not reappear during the following two months of follow-up.

sergio serrano belmar

18,963 просмотров • 1 год назад

In 1993 CNN warned against pregnancy ultrasound and had the FDA admit it was aware of its dangers. Remarkably, the FDA raised the maximum allowable ultrasound dose by 8 times (despite data showing the old dose was too high) and all those dangers were forgotten. Ultrasound causes a dose dependent injury to the organs and cells that fetuses are particularly susceptible to (especially early in life when ultrasounds have no medical value). Those harms include: •Genetic damage, significant damage to cellular structures (e.g., mitochondria, microtubules and the nucleus). •Initiating programmed cell death. •In mice and monkeys, significantly impaired learning, memory, activity, and sociability. •Fetal death. •Hemorrhages. •A wide range of congenital malformations. The Chinese in turn conducted a series of studies showing the low doses of ultrasound created those injuries in the placenta, pituitary gland, eyes, immune system, kidneys, liver, ovaries, testicles (and sperm), and the brain’s neurons and glial cells. Additionally, in humans, ultrasound has also been linked to miscarriages, premature ovulation, male infertility, fetal growth restrictions, altered neurological function, developmental delays. Conversely, ultrasound has not been proven to improve pregnancy outcomes (rather it just leads to more frequent C-sections, prenatal testing, anxiety for the parents, abortions and neonatal distress) Rather, all it can do most of the time is (sometimes erroneously) tell parents to abort their baby or subject it to invasive (and harmful tests), all of which creates immense unnecessary anxiety and anguish for the parents. I complied the 200+ studies proving all of this in the article below.

A Midwestern Doctor

783,400 просмотров • 1 год назад

You become injured. ⠀ ⠀ You’re placed in a cast, or sling. ⠀ ⠀ You are told to not train upper body, and just build the lower half, or vice versa. ⠀ ⠀ You don’t even bother training your non-injured, non-dominant (in most baseball, upper extremity related cases) side, because why would you need to? ⠀ ⠀ Here’s why you should absolutely train your non-injured side, even if your injured side is immobilized. ⠀ ⠀ Cross education (CE) occurs after unilateral training where performance of the untrained, contralateral (in this case injured) limb is enhanced.⠀ ⠀ Increased neural drive originating from the “untrained” motor cortex contributes to the cross education effect.⠀ ⠀ A few studies have shown that CE can preserve or spare strength and decrease atrophy on the untrained, injured limb. ⠀ ⠀ In most baseball related cases, injuries of the upper extremity most often tend to be on the dominant side. Chances are there is already some sort of imbalance in strength and or hypertrophy between sides. It is also likely that when rehabbing from that injury, we tend to attend less and be less detailed with the non-injured, non-dominant side. So the chances of there being an imbalance post-injury are likely. It’s the reason why players get hurt, rehab, come back, and in some cases end up injuring the contralateral side shortly thereafter. (Of course we see that more with lower extremity injuries.) ⠀ ⠀ In a study conducted by Justin W. Andrushko and co. They took 16 participants who were immobilized with a cast, and assigned them to a 4-week resistance training forearm program on the non-injured limb. Here’s what they found ⬇️ “The nondominant forearm of 16 participants was immobilized with a cast, and participants were randomly assigned to a resistance training (eccentric wrist flexion, 3 times/week) or control group for 4 weeks. Pre- and post testing involved wrist flexors and extensors eccentric, concentric and isometric maximal voluntary contractions (via dynamometer), muscle thickness (via ultrasound), and forearm muscle cross-sectional area (MCSA; via peripheral quantitative computed tomography). Only the training group showed strength preservation across all contractions in the wrist flexors of the immobilized limb (training: −2.4% vs. control: −21.6%; P = 0.04), and increased wrist flexors strength of the nonimmobilized limb (training: 30.8% vs. control: −7.4%; P = 0.04). Immobilized arm MCSA was preserved for the training group only (training: 1.3% vs. control: −2.3%; P = 0.01). Muscle thickness differed between groups for the immobilized (training: 2.8% vs. control: −3.2%; P = 0.01) and nonimmobilized wrist flexors (training: 7.1% vs. control: −3.7%; P = 0.02). Strength preservation was nonspecific to contraction type (P = 0.69, η2p = 0.03) yet specific to the trained flexors muscle. These findings suggest that eccentric training of the nonimmobilized limb can preserve size of the immobilized contralateral homologous muscle and strength across multiple contraction types.”

Ryan Aguirre, CSCS

79,648 просмотров • 3 лет назад

Consent✅ "I’m at the Point of Breaking – Hang 10, take it thighs-an easy, I’m Hunting for a solution" Runner, surfer Massive ramp up in marathon training – rapid onset medial mid to lateral burning thigh pain (see pain map below) with low grade parasthesiae Exacerbated by deep knee flexion and running beyond 20 mins and a faster pace Struggled further on surfing holiday in prone on board and kneeling MRI excluded femoral bone stress injury and no adductor injury or knee intra-articular / ligamentous injury OE – Meniscal and ligamentous testing normal Lumbar spine and hip joint cleared POCUS video reel – Adductor magnus tendon & wider musculature normal Saphenous nerve swollen at mid Hunter’s canal point – almost same calibre as the adjacent femoral artery! (point of maximal tenderness with probe pressure - Tinel's positive) US guided hydrodissection (LS) – soft tissue planes around SN seen to open up effectively Post procedure – complete abolition of pain on treadmill running and deep squats for the first time in 8 months (excuse the language) Pearls - This area is diagnostic ‘No Man’s Land’ – ie, if there is no femur bony pathology, and in the absence of trauma, it can only really be neural ‘Adductor splint syndrome’ – a form of bone stress injury – is one of the key medial thigh pain differentials in runners Research links – ‘Surfer's neurapraxia - an uncommon surfing injury of the saphenous nerve’ ‘Adductor insertion avulsion syndrome (thigh splints): spectrum of MR imaging features’

James Noake

16,833 просмотров • 3 месяцев назад

One of the interesting findings from studies comparing social pain and physical pain is this: if you ask people directly which they would rather experience, most say social pain. Physical pain is extremely aversive. People dislike it intensely. When asked to imagine experiencing one or the other, they typically rate physical pain as more unpleasant than the social pain of embarrassing yourself on stage, being betrayed by a friend, or being dumped by a romantic partner. But an interesting study from about ten years ago approached the question differently. Instead of asking people to imagine pain, the researchers asked participants to recall real experiences. Some were asked to remember moments of physical pain—being in a serious car accident, falling out of a tree and breaking a bone, or some other injury. Others were asked to recall socially painful experiences—being broken up with, going through a divorce, being betrayed by a friend, or embarrassing themselves at an important work event. When recalling these events, people reported that the socially painful memories felt more painful than the physically painful ones. When I first read this study, I was a little skeptical. But then I thought back to the times in my own life when I experienced physical pain. The memory of it tends to be vague. If you’ve broken a bone, been punched, or stubbed your toe, it’s surprisingly difficult to recreate the sensation in your mind once the pain is gone. Social pain is different. It’s much easier to recall vividly. I can remember moments when I felt embarrassed, betrayed, or misled, and those memories can still bring back the emotional sting. Many of those experiences are easy to relive even years later.

Rob Henderson

15,947 просмотров • 6 месяцев назад