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There is a growing interest in the use of biologic agents such as platelet-rich plasma and mesenchymal stem/stromal cells to treat musculoskeletal injuries, including meniscal tears. Although previous research has documented the role of diagnostic ultrasound to evaluate meniscal tears, sonographically guided (SG) techniques to specifically deliver therapeutic agents into the meniscus have not been...
Chronic exertional compartment syndrome (CECS) is a common cause of exertional leg pain. It is commonly treated with a surgical fasciotomy, which has a surgical complication rate of up to 16% and takes approximately 6-12 weeks to return to preprocedure activity levels. Therefore, the development of a less invasive, effective outpatient intervention to treat CECS is desirable.To describe and validate...
Differential motion between the plantaris and Achilles tendons has been hypothesized to contribute to pain in some patients presenting with Achilles tendinopathy. However, objective evidence of differential Achilles-plantaris motion is currently lacking from the literature.To determine whether differential, multidirectional motion exists between the plantaris tendon (PT) and Achilles tendon (AT) as...
To assess the biological effects of passage through clinically relevant needles on the viability and metabolic activity of culture-expanded, human adipose tissue–derived mesenchymal stromal/stem cells (AMSCs).Prospective observational pilot study.Academic medical center.Patient-derived clinical-grade culture expanded AMSCs.AMSCs were passed through syringes without a needle attached (control), with...
Biomechanical studies have demonstrated that the lower trapezius (LT) facilitates normal shoulder function, and given its potential role in causing and/or perpetuating dysfunction, clinicians have begun to evaluate and rehabilitate the LT in the context of comprehensive shoulder rehabilitation programs. Although some studies have compared side-to-side differences in LT thickness among nonthrowers,...
Leg pain is a common condition in athletes as well as in the general population, and has a broad differential diagnosis that includes musculoskeletal, vascular, rheumatologic, and neurologic etiologies. Idiopathic inflammatory myopathy (IM) is a relatively uncommon but recognized etiology of leg pain. In this case, we describe an acute presentation of IM in an athlete resulting in leg pain and activity...
To describe and validate a sonographically guided (SG) semimembranosus (SM) bursa injection technique in an unembalmed cadaveric model.Prospective, cadaveric laboratory investigation.Academic institution procedural skills laboratory.Ten unembalmed cadaveric thigh-knee-ankle-foot specimens from 4 male and 6 female donors ages 55-92 years (mean 76.2 years) with body mass indices of 15.4-31.8 kg/m2 (mean...
To formally examine the sonographic appearance of the elbow ulnar collateral ligament (UCL) at 30° versus 70° of elbow flexion in asymptomatic baseball pitchers.A prospective, cross-sectional design.Sports medicine clinic in a tertiary academic medical center.Thirty asymptomatic adolescent baseball pitchers 13-18 years of age (mean 15.8 years), with at least 3 years of continuous pitching experience...
Ischiofemoral impingement is caused by compression of the quadratus femoris muscle between the ischial tuberosity and lesser trochanter. The evaluation of ischiofemoral impingement includes radiologic studies to evaluate the ischiofemoral space dimensions. No prior study has evaluated the effect of femoral position on ischiofemoral space dimensions.To determine whether the dimensions of the ischiofemoral...
To describe and validate a practical technique for sonographically guided anterior cruciate ligament (ACL) injections.Prospective, cadaveric laboratory investigation.Procedural skills laboratory in a tertiary medical center.Ten unembalmed, cadaveric mid–thigh-knee-ankle foot specimens (5 left knees and 5 right knees; 5 male and 5 female) from 10 donors aged 76 to 93 years (mean 85.6 years) with body...
This case report describes a 43-year-old woman with a previous anterior cruciate ligament reconstruction and medial meniscectomy who presented with right knee dysesthesias radiating into her medial ankle with associated allodynia. An extensive work-up was pursued, without a definitive diagnosis found or improvement in the patient's symptoms. Eventually, she was referred to Pain Medicine for an ultrasound-guided...
To prospectively study the effects of an incentivized exercise program on physical activity (PA), quality of life (QOL), and burnout among residents and fellows (RFs) in a large academic medical center.In January 2011, all RFs at Mayo Clinic in Rochester, Minnesota (N=1060), were invited to participate in an elective, team-based, 12-week, incentivized exercise program. Both participants and nonparticipants...
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