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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Heel pain – plantar fasciitis is inflammatory thickening of the plantar fascia, usually at the origin from the calcaneum and is a common cause of heel pain. The diagnosis is usually clinical but in refractory cases ultrasound can be used to confirm the diagnosis, exclude other conditions such as plantar fibroma or fibromatosis or to guide steroid injection. Achilles tendon pathology is another common cause of heel pain located posteriorly. Chronic tendinopathy is very common as the Achilles tendon also carries a major load during ambulation and is subject to acute inflammation or tears sometimes related to relatively trivial trauma. Ultrasound and MRI can establish the diagnosis of tendinopathy and assess the presence of tears. Partial or complete rupture can be assessed. Dynamic ultrasound can also assess the tendon gap in complete rupture.
Much work remains to reach consensus on musculoskeletal injury risk in military service members: A systematic review with meta-analysis
Published in European Journal of Sport Science, 2022
Daniel I. Rhon, Joseph M. Molloy, Andreas Monnier, Ben R. Hando, Phillip M. Newman
Of the 101 remaining studies, 27 were specific to a single diagnosis (e.g. plantar fasciitis) and were excluded from the meta-analysis. The online supplementary appendix (SA2) includes a descriptive list of predictors for those 27 studies. We extracted data from, and assessed the quality of the remaining 74 studies, representing 13 countries and 2,854,717 total service members (82.6% men). Primary targets were trainees for 31 (41.9%) studies, active component personnel for 21 (28.4%) studies, conscripts for nine (12.2%) studies, cadets for nine (12.2%) studies, and special operations forces for four (5.4%) studies. Prospective cohort design accounted for 43 (58.1%) studies, followed by 20 retrospective cohort studies (27.0%), six randomized clinical trials (8.1%), and five case–control studies (6.8%).
GnRHa (‘Puberty Blockers’) and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood and Freedom of Expression
Published in The New Bioethics, 2020
David Pilgrim, Kirsty Entwistle
In light of all of this contention, the rationale and fate of the original ‘Dutch protocol’ invites scrutiny. Genital surgeries are not available until the patient is at least 18 years old. Even so, in the initial Dutch cohort one of the 55 patients, who began their gender transition as an adolescent, died at approximately 20 years old. The cause of death was necrotizing fasciitis, following vaginoplasty (de Vries et al.2014). Proponents of the Dutch protocol confirm its success, despite this fatality and the fact that five other patients from the first cohort failed to participate in the one year follow up (de Vries et al.2014). Furthermore, there were important missing data; at that follow up point, none of the females had yet undergone the risky procedure of phalloplasty.
The biomechanical difference between running with traditional and 3D printed orthoses
Published in Journal of Sports Sciences, 2019
Shiwei Mo, Sam H.S. Leung, Zoe Y.S. Chan, Louis K.Y. Sze, Kam-Ming Mok, Patrick S.H. Yung, Reed Ferber, Roy T.H. Cheung
During running, the foot exhibits between 6–8 degrees of rearfoot eversion in order to improve shock absorption during the weight acceptance phase (Cheung, Chung, & Ng, 2011; Donatelli, 1985). Prolonged and/or excessive foot pronation may lower the medial longitudinal arch and increase tension of the plantar fascia (Bolgla & Malone, 2004; Ferber & Hettinga, 2016), thereby resulting in plantar fasciitis. Additionally, increased impact forces experienced during running could lead to increased tension to the plantar fascia (Bolgla & Malone, 2004), suggesting a relationship between high vertical loading rate and the development of this MSK injury (Davis & Futrell, 2016; Pohl et al., 2009). However, few studies have investigated the inter-relationships among excessive foot eversion, high impact loading, and plantar fasciitis.