Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries.

ABSTRACT: Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.

Diagnostic utility of shear wave elastography in musculoskeletal injuries: A narrative review.

Shear wave elastography (SWE) is an emerging and promising ultrasound modality, and is more recently employed in the diagnosis of musculoskeletal (MSK) pathologies. SWE evaluates tissue stiffness by measuring the speed of propagating acoustic waves through body tissue structures. Knowing the variations in stiffness of MSK soft tissue can provide helpful diagnostic insight for the evaluation of pathology in muscles, tendons, ligaments, nerves, and other soft tissues. The goal of this review is to synthesize recent literature on the utility of SWE for MSK pathology diagnosis. This review reveals that SWE adds important diagnostic data for the evaluation of several pathologies, such as median mononeuropathy at the wrist, Achilles tendinopathy, and plantar fasciitis. The review also reveals a lack of evidence pertaining to appropriate standardization of use and the connection to reliable and valid diagnostic benefit in the clinical setting.

Association of Academic Physiatrists Residency and Fellowship Program Directors' Resident Recruitment Subcouncil Position Paper on Residency Recruitment.

ABSTRACT: Residency recruitment practices have undergone significant changes in the last several years. Interviews are now conducted fully virtually leading to both positive and negative downstream effects, including decreased cost to applicants and programs, decreased time away from clinical activities, flexibility in scheduling, and increased applications for applicants and program directors. In response to these changes, the Association of Academic Physiatrists Residency and Fellowship Program Directors Council convened a workgroup consisting of program directors, program coordinators, residents, and medical students who reviewed the available literature to provide an evidence-based set of best practices for program leaders and applicants. Available data from the Association of American Medical Colleges and its relevance to future recruitment cycles are also discussed.

Safeguarding strategies in athletes with intellectual disabilities: A narrative review.

Compared to their non-disabled peers, athletes with disabilities are at an increased risk of interpersonal violence in sport. Athletes with intellectual disabilities specifically may face compounded risk due to impaired communication and social challenges. Despite the inherent risk of interpersonal violence in athletes with intellectual disabilities, there is a paucity of literature focused on safeguarding strategies in this population, and no global consensus prevention guidelines exist. The goal of this review was to synthesize the literature on interpersonal violence in athletes with intellectual disabilities and propose an evidence-informed safeguarding framework. Future research and practice should emphasize tailored training on appropriate athlete-protection strategies and ways to recognize and respond to suspicions of abuse in this population. Given the benefits of sports participation for persons with intellectual disabilities, implementation of fit-for-purpose safeguarding strategies would help address any elevated risk of interpersonal violence. Formal monitoring and evaluation of these initiatives can help minimize interpersonal violence.

Reactive Arthritis in a 37-Year-Old Female With SARS-CoV2 Infection.

We report the case of a 37-year-old female who presented for evaluation of acute 10/10 right hand pain, 12 days after testing positive for SARS-CoV2. The patient was admitted to the hospital due to the severity of her pain. As an inpatient, extensive workup by the medicine team and rheumatology revealed no structural, vascular, or neurogenic cause of her pain. The patient's blood work was unremarkable for elevations in lyme serology, antinuclear antibody (ANA), rheumatoid factor, and uric acid. It was determined that the cause of her pain was most likely reactive arthritis (ReA) secondary to her SARS-CoV2 infection. She was treated with voltaren gel, neurontin, and oral dilaudid as needed and discharged. Upon follow-up, her pain improved and she was prescribed a wrist splint, ultram, and occupational therapy for perceived wrist tendinitis. To our knowledge, this is the first description of a case of ReA caused by the SARS-CoV2 virus.