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Hip Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Lumbosacral strain is a chronic soft tissue injury in the lumbar region that causes low back pain. Strain means the tearing of the lumbosacral muscles, tendons, and fascia. Among the chronic back pain diseases, lumbosacral strain is a common pain. It is often found in middle-aged patients, especially patients with assigned female reproductive systems.
Fascia and the Circulatory System
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
Anita Boser, Kirstin Schumaker
Fascia plays an important role in vascular regulation in the lower leg; the pressure created by fascia compartments and blood supply requires a stable balance. The deep fascia of the leg, especially that of the posterior compartment, constrains the muscles as they contract to generate pressure that pumps blood through the valved veins.29 Muscular and fascial weakness can diminish the pump and result in venous insufficiency.30 Conversely, compartment syndrome develops when venous drainage is impaired, but arterial flow remains normal. This can be due to acute or repetitive strain injury. Increased fascial thickness and stiffness has been found in conjunction with chronic anterior compartment syndrome.31,32 Although fasciotomy is indicated in some cases of chronic exertional compartment syndrome, it does diminish the calf muscle pump action and may increase the risk for venous insufficiency.33 Another interesting connection between fascia and the vasculature in the lower leg is the uncommon case of muscle herniation through the epimysium, suggested to occur at sites of vein perforation, which is often mistaken for varicosity or hematoma.34 Although usually asymptomatic, a case report of peroneus longus herniation resulted in burning sensations.35
Elastography
Published in Peter R Hoskins, Kevin Martin, Abigail Thrush, Diagnostic Ultrasound, 2019
Concerning strain imaging: Strain in the tissues may be induced by natural movements such as breathing and cardiac pulsationThe strain generally increases with increasing depth from the transducerThe displayed image is of elastic modulusSoft tissues generally display low strainHard tissues generally display low strain
Advances in multi-modality imaging for constrictive pericarditis and pericardial inflammation: role of imaging-guided therapy
Published in Expert Review of Cardiovascular Therapy, 2023
Tahir S Kafil, Tom Kai Ming Wang, Ankit Agrawal, Muhammad Majid, Alveena B Syed, Erika Hutt, Ben Alencherry, Joshua A Cohen, Sachin Kumar, Agam Bansal, Brian P Griffin, Allan L Klein
Strain imaging may provide some added information in CP. A study by Sengupta et al. compared strain in CP and restrictive cardiomyopathy [18]. They found that left ventricular global longitudinal strain, displacement, and early diastolic velocities at the LV base were unchanged compared to controls. However, there was significantly reduced circumferential strain, torsion, and early diastolic apical untwisting velocities. This highlights the abnormal diastolic relaxation in CP. Further, after pericardiectomy, longitudinal early diastolic LV basal myocardial velocities significantly decreased [18]. A second study by Kusunose et al. assessed echocardiographic strain imaging in 52 patients with CP [19]. They found that CP was associated with lower regional longitudinal systolic strain ratios compared to restrictive cardiomyopathy, had depressed anterolateral wall strain, depressed right ventricular free wall systolic strain, and preserved septal wall strain [19]. Following pericardiectomy, there was improvement in certain strain regions. Both studies illustrate the effect of constriction on cardiac mechanics.
Trends and epidemiology of knee extensor mechanism injuries presenting to United States emergency departments from 2001 to 2020
Published in The Physician and Sportsmedicine, 2023
Joseph G. Lyons, Humza M. Mian, Garrhett G. Via, David A. Brueggeman, Anil B. Krishnamurthy
Cases from the twenty-year period from 2001 to 2020 were considered for selection. An EM injury was defined as either a QTR, a PF, or a PTR. To isolate all potential EM injuries, the NEISS database was queried for all upper leg (code 81) and knee (code 35) injuries diagnosed as a strain or sprain (code 64) or a fracture (code 57). Although all PFs and PTRs (and a majority of QTRs) were coded as involving the knee (code 35), a minority of QTRs were identified within the upper leg (code 81) category and thus the upper leg code was included in the initial search. ‘Pulled or torn ligament, muscle, or tendon’ does not have its own injury diagnosis code and falls under the broad category of ‘strain or sprain’ (code 64). Each NEISS database record carries a weighting factor which allows for the conversion of cases (unweighted records) to national estimates (weighted estimates) by accounting for the NEISS stratified probability sampling design. Results, therefore, include the number of unweighted cases as well as the total annual case numbers which are estimated from the sum of individual case weights. The initial query resulted in n = 199,667 unweighted records, representing a total weighted estimate of 7,639,948 (95% CI = 6,634,173–8,645,722) emergency department visits related to soft tissue/bony injuries about the knee and upper leg.
Volleyball-related injuries in adolescent female players: an initial report
Published in The Physician and Sportsmedicine, 2021
Joseph G. Wasser, Brady Tripp, Michelle L. Bruner, Daniel R. Bailey, Rachel S. Leitz, Jason L. Zaremski, Heather K. Vincent
Based on participant responses, the type of injury was categorized by sprain/strain, ligament tear or rupture, and bony injury (overuse stress-related or acute fracture). The type of injury expressed as a percent of the number of injuries at that site is listed in Table 3. The greatest number of sprains/strains occurred at the ankle, knee, finger, and shoulder. The greatest number of ligament ruptures occurred most frequently in the ankle, foot, and knee. Fractures were most common in the fingers and ankles. A total of 76.7% of all shoulder injuries were sprains and strains. The highest proportions of fractures occurred in the wrist, elbow/arm, and foot (25.0%–30.5% of all injuries at these sites). For every age, the prevalence of injuries reported at each site was determined. Fifteen-year olds reported the highest prevalence of injuries at six of the listed body sites (foot, knee, hip, back, shoulder and fingers) and 13-year olds reported the highest injury rates at three sites (hip, elbow and wrist). Seventeen-year olds reported the highest frequency of all injuries at the ankle (57.1%).