Neuromyelitis Optica Spectrum Disorders and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.

For over two centuries, clinicians have been aware of various conditions affecting white matter which had come to be grouped under the umbrella term multiple sclerosis. Within the last 20 years, specific scientific advances have occurred leading to more accurate diagnosis and differentiation of several of these conditions including, neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein antibody disease. This new understanding has been coupled with advances in disease-modifying therapies which must be accurately applied for maximum safety and efficacy.

Upper extremity overuse injuries in pediatric athletes: clinical presentation, imaging findings, and treatment.

UNLABELLED: Given the frequency and severity of overuse injuries in pediatric athletes and the potential for long-term deleterious effects, it is important for radiologists to have a comprehensive understanding of these injuries and their imaging spectrum. This article addresses chronic overuse injuries involving the upper extremity in the pediatric athlete. Chronic upper extremity overuse injuries in competitive pediatric athletes yield imaging findings that can be subtle, obvious and characteristic, or atypical. Prompt application of the appropriate imaging modalities and their accurate interpretation expedites management, returning the pediatric athlete to the playing field while minimizing long-term adverse outcomes. SUMMARY STATEMENT: Proper modality selection and interpretation in the imaging evaluation of upper extremity overuse injuries in pediatric athletes include an understanding of skeletal development, mechanism of injury, and clinical presentation to provide accurate diagnoses and mitigate long-term adverse sequelae. LEARNING OBJECTIVES: After reading this article and taking the test, the reader will be able to: • Describe the clinical presentation and imaging characteristics of a variety of pediatric overuse injuries in the upper extremity including little league shoulder, rotator cuff tendinosis, gymnast wrist, climber's finger, and myriad pathologies about the elbow. • Explain how the physis plays a crucial role in pediatric overuse injury and how to evaluate physeal injury in a multimodal approach. • Understand the clinical management for certain pediatric overuse injuries, especially those that have potential for long-term and/or permanent disability.

Observation of limb movements reduces phantom limb pain in bilateral amputees.

BACKGROUND: Mirror therapy has been demonstrated to reduce phantom limb pain (PLP) experienced by unilateral limb amputees. Research suggests that the visual feedback of observing a limb moving in the mirror is critical for therapeutic efficacy. OBJECTIVE: Since mirror therapy is not an option for bilateral lower limb amputees, the purpose of this study was to determine if direct observation of another person's limbs could be used to relieve PLP. METHODS: We randomly assigned 20 bilateral lower limb amputees with PLP to visual observation (n = 11) or mental visualization (n = 9) treatment. Treatment consisted of seven discrete movements which were mimicked by the amputee's phantom limbs moving while visually observing the experimenter's limbs moving, or closing the eyes while visualizing and attempting the movements with their phantom limbs, respectively. Participants performed movements for 20 min daily for 1 month. Response to therapy was measured using a 100-mm visual analog scale (VAS) and the McGill Short-Form Pain Questionnaire (SF-MPQ). RESULTS: Direct visual observation significantly reduced PLP in both legs (P < 0.05). Amputees assigned to the mental visualization condition did not show a significant reduction in PLP. INTERPRETATION: Direct visual observation therapy is an inexpensive and effective treatment for PLP that is accessible to bilateral lower limb amputees.