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One Legged Hyperextension

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1. One Legged Hyperextension

One Legged Hyperextension One Legged Hyperextension Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 One Legged Hyperextension One (...) Legged Hyperextension Aka: One Legged Hyperextension , Stork Standing Test , One Leg Standing Lumbar Extension Test II. Indications ination Sacroiliac Joint Examination III. Technique Patient stands on one foot facing wall Other foot placed against the wall for support Patient hyperextends backwards IV. Interpretation Positive test Sacroiliac joint region pain increased on hyperextension Causes of positive test Images: Related links to external sites (from Bing) These images are a random sampling

2018 FP Notebook

2. Lower Extremity Alignment and Dynamic Control With Associated Injury Risk in College Athletes With Knee Hyperextension

number of saved studies (100). Please remove one or more studies before adding more. Lower Extremity Alignment and Dynamic Control With Associated Injury Risk in College Athletes With Knee Hyperextension The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details (...) . In athletes, landing from a jump on an extended knee is one of the common reasons resulting in ACL injury. Little is known about the injury rate of athletes with knee hyperextension who participate in sports involving jump-landing activities. The aim of the study is to explore if knee hyperextension is associated with poor lower extremity alignment and dynamic control and injury rate in athletes requiring jump-landing activities. One of the study hypothesis is that athlete with knee hyperextension can

2018 Clinical Trials

3. One Legged Hyperextension

One Legged Hyperextension One Legged Hyperextension Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 One Legged Hyperextension One (...) Legged Hyperextension Aka: One Legged Hyperextension , Stork Standing Test , One Leg Standing Lumbar Extension Test II. Indications ination Sacroiliac Joint Examination III. Technique Patient stands on one foot facing wall Other foot placed against the wall for support Patient hyperextends backwards IV. Interpretation Positive test Sacroiliac joint region pain increased on hyperextension Causes of positive test Images: Related links to external sites (from Bing) These images are a random sampling

2015 FP Notebook

4. CRACKCast E057 – Knee and Lower Leg

CRACKCast E057 – Knee and Lower Leg CRACKCast E057 – Knee and Lower Leg - CanadiEM CRACKCast E057 – Knee and Lower Leg In , by Adam Thomas January 9, 2017 This episode of CRACKCast covers Chapter 57 of Rosen’s Emergency Medicine, Knee and Lower Leg. Continuing on with the orthopaedic chapters and objectives, this episode reviews the relevant approaches to knee and lower leg injuries that are actionable in the emergency department setting. Shownotes – Also check out the EM Cases Rapid Review (...) Interiorly = popliteal artery + vein, peroneal and tibial nerves 2) Describe Ottawa knee Rule Goal of radiography = rule out a fracture! X-ray isn’t perfectly sensitive for finding subtle fractures Tips: Carefully trace the cortex Evaluate for a lipohemarthrosis The OKR: “Radiography necessary with any one of:” Age > 55 yrs Inability to transfer weight from one foot to the next four times at the time of injury AND in the ED (able to walk at least 4 steps) Inability to flex the knee to 90 degrees Isolated

2017 CandiEM

5. Overview of sport-related injuries

, pain does not radiate to the legs or beyond the knee. LBP may arise as an overuse injury among sportsmen such as weightlifters. Calhoon G, Fry AC. Injury rates and profiles of elite competitive weightlifters. J Athl Train. 1999;34:232-238. http://www.ncbi.nlm.nih.gov/pubmed/16558570?tool=bestpractice.com The character of chest pain should be determined to help differentiate between cardiac, respiratory, musculoskeletal, and other causes. Pain in the chest may be referred (e.g., from cervical spine (...) considered to be any fracture of the femur distal to the femoral head and proximal to a level a few centimetres below the lesser trochanter. A strain is an injury to the muscle or musculotendinous junction, whereas a sprain is an injury to the ligament. Muscle contusion occurs when a muscle is subjected to a sudden, heavy compressive force, such as a direct blow to the muscle. Acute ankle injury is one of the most common musculoskeletal injuries in athletes, accounting for 20% of all sport injuries

2018 BMJ Best Practice

6. Management of Stroke in Neonates and Children Full Text available with Trip Pro

attributable to focal brain infarction or hemorrhage—applies to children as reflected by the National Institutes of Health (NIH) Common Data Elements definition. , However, in the neonatal period, the acute presentation can be missed. Thus, it is important for pediatric health professionals to be able to recognize stroke at different ages and to treat stroke to preserve brain function and to promote repair and recovery. Classification There are different ways of characterizing pediatric stroke. One (...) segment infarction was most common, venous periventricular infarction was next highest and accounted for 75% of subcortical injuries. Motor outcomes in this cohort were predicted by basal ganglia involvement, including leg hemiparesis, spasticity, and need for assistive devices. Nonmotor outcomes were associated with cortical involvement, including cognitive/behavioral outcomes, visual deficits, and epilepsy. Risk Factors Risk factors include both maternal and neonatal factors. Normal activation

2019 American Heart Association

7. Management Of Haemophilia

out), NHS (No heel strike), EHO (early heel off) OR DSP (decreased stance phase), LKE (limited knee extension), KH (knee hyperextension) 0 = All skills are within normal limits Global Score 1 = One skill is not within normal limits 2 = Two skills are not within normal limits 3 = Three skills are not within normal limits 4 = No skills are within normal limits NE = Non-evaluable *Axial alignment to be observed and not scored* AXIAL ALIGNMENT To be measured in weight- bearing position Left Knee Right (...) through ROM gravity eliminated (gr.2), or through partial ROM gravity eliminated (gr.2-) 4 = Trace (gr.1) or no muscle contraction (gr.0) NE = Non-evaluate Duration 0 = No swelling or 10 ° Muscle Atrophy 0 = None 1 = Mild 2 = Severe Extention loss Contralateral: 0 = 10 ° Global Gait (walking, stairs, running, hopping on 1 leg) 0 = All skills are within normal limits 1 = One skill is not within normal limits 2 = Two skills are not within normal limits 3 = Three skills are not within normal limits 4

2018 Ministry of Health, Malaysia

8. Bruising

as bruising on exposed areas (such as the arms or legs) after minor trauma. May be associated with menorrhagia. Hereditary haemorrhagic telangiectasia (HHT) A rare autosomal dominant genetic disorder which leads to mucocutaneous telangiectasia of the skin, mucous membranes, and organs. There may be a positive family history, recurrent nosebleeds, fatigue, nail changes, and hair loss. Ehlers-Danlos syndrome This causes joint hypermobility and skin translucency and hyperextensibility. It may present (...) . Located above or near bony prominences on the front of the body (such as the forehead, knees, or shins). Non-accidental injury — see the section on for more information. This may include: Child maltreatment. Domestic violence. Self-inflicted injury (commonly on the legs or areas within easy reach). Complementary therapies — such as cupping (where cups create local suction on the skin, to promote healing) or coining (where coin rubbing causes dermabrasion, to relieve symptoms such as myalgia

2017 Prodigy

9. CRACKCast E176 – Pediatric Musculoskeletal Disorders

-Perthes disease is an idiopathic avascular necrosis of the hip that has a peak presentation between 5 and 7 years of age. It is bilateral in 20% of cases. A slipped capital femoral epiphysis (SCFE) is a posteroinferior slippage of the proximal femoral epiphysis on the metaphysis. It is more common in boys than girls, more common with obesity, and bilateral in 80% of cases. It is best seen on a cross-table or frog leg lateral view radiograph; 90% are stable. Osgood-Schlatter disease is the most common (...) form of apophysitis. The onset is insidious, and treatment is conservative and symptomatic. A sudden onset of apophyseal pain is more suggestive of an avulsion fracture. Rosen’s In Perspective : Pediatric fracture descriptions include bone location (diaphysis, metaphysis, physis, or epiphysis), relationship of fracture fragments to one another (angulation and displacement), and relationship of fracture fragments to adjacent tissue (open or closed), and involvement of the articular surface

2018 CandiEM

10. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

) may be used to assess knee-related quality of life. Examination — Physical Performance Measures 2018 Recommendation Clinicians may administer appropriate clinical or field tests, such as single-legged hop tests (eg, single hop for distance, cross-over hop for distance, triple hop for distance, and 6-m timed hop), that can identify a patient's baseline status relative to pain, function, and disability; detect side-to-side asymmetries; assess global knee function; determine a patient's readiness (...) assessment, assessment of knee active range of motion, maximum voluntary isometric or isokinetic quadriceps strength testing, forced hyperextension, maximum passive knee flexion, McMurray's maneuver, and palpation for joint-line tenderness. Clinicians may administer the appropriate physical impairment assessments of body structure and function, at least at baseline and at discharge or 1 other follow-up point, for all patients with articular cartilage lesions to support standardization for quality

2018 American Physical Therapy Association

11. Spasticity in adults: management using botulinum toxin - 2nd edition

38 11 References 40 Appendix 1: Evaluation of evidence for these guidelines 47 Background 47 The GRADE process 47 Methodology 48 The NSF typology of evidence 49 iv © Royal College of Physicians 2018Contents Appendix 2: Injection sites for BoNT-A 53 Appendix 3: Tools to assess outcome 64 Structured approach to Goal Attainment Scaling 64 The Numeric Graphic Rating Scale (NGRS) 66 The SPIN Screen 67 Associated Reaction Rating Scale (ARRS) 68 Arm Activity measure (ArmA) 70 Leg Activity measure (LegA (...) are: ° appropriate patient selection ° establishment of clear goals for treatment ° clear establishment of the immediate and ongoing treatment programme. • BoNT is licensed in the UK for treatment of focal spasticity in the arm and leg. It has also become an accepted part of routine management of spasticity in other muscle groups, such as neck and jaw muscles. • BoNT should only be injected by clinicians experienced in the assessment and management of spasticity. It should not be used in isolation, but as part

2018 British Society of Rehabilitation Medicine

12. Perinatal substance use: neonatal

tight flexion of the arms and legs that is unable to slightly extend the arms or legs Excoriation First appearance or increase on baby’s chin, knees, cheeks, elbow, toes or nose due to friction burn not nappy area excoriation from loose stools Myoclonic jerks Baby exhibits twitching movements of the muscles of the face or extremities or jerking movements of the arms or legs Generalised convulsions Baby has generalised activity involving tonic (rigid) extensions of all limbs (or may be limited to one (...) Dusky, pale, mottled, cyanotic • Tremors, startles, twitches • Yawning • Gagging, spitting up • Hiccoughing • Straining • Sneezing, coughing • Sighing • Flaccidity o Trunk, extremities, face • Hypertonicity with hyperextension of: o Legs, arms, trunk • Finger splays • Facial grimace • Hand on face, fisting • Fetal tuck • Frantic diffuse activity • Diffuse sleep-wake states • Fussing or irritability • Staring or gaze averting • Panic or worried alertness • Glassy eyed alertness • Rapid state

2017 Queensland Health

13. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatric and Congenital Cardiology: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards Full Text available with Trip Pro

guidelines, and determine statistical significance in our patient populations. There is a wide range of disease processes across a relatively small set of patients in pediatric and congenital heart disease; this fact is in contrast to adult cardiac disease where there is a large population of patients who experience a more homogenous set of disease processes. In a year, a cardiac center in adult medicine is likely to treat thousands of patients who present with one of only a few disease processes. Adult (...) this problem, there are often insufficient patients at any one heart center to accumulate sufficient evidence to define optimal patient care. Clinical outcome measures to determine the effect of inpatient and outpatient care are evolving slowly, and there is no universal standardized clinical record to monitor a patient’s course, long-term outcomes, and comorbidities or quality-of-life indicators. Collaborative multi-institutional efforts are required to improve the quality of care for children

2017 American Heart Association

14. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Full Text available with Trip Pro

associated with knee ligament sprain. Examination – Physical Performance Measures Clinicians should administer appropriate clinical or field tests, such as single-legged hop tests (eg, single hop for distance, crossover hop for distance, triple hop for distance, and 6-meter timed hop), that can identify a patient's baseline status relative to pain, function, and disability; detect side-to-side asymmetries; assess global knee function; determine a patient's readiness to return to activities; and monitor (...) and b7601 Control of complex voluntary movements . The primary ICF body structure codes associated with knee stability and movement coordination impairments are s75011 Knee joint, s75002 Muscles of thigh, s75012 Muscles of lower leg , and s75018 Structure of lower leg , specified as ligaments of the knee. The primary ICF activities and participation codes associated with knee stability and movement coordination impairments are d2302 Completing the daily routine and d4558 Moving around , specified

2017 American Physical Therapy Association

15. Addyi - Flibanserin

was 83/49 mmHg (baseline blood pressure was 120/75 mmHg). In addition, subjects receiving flibanserin and high dose ethanol also exhibited similar decreases in blood pressures. When standing from a sitting position, the magnitude of systolic blood pressure reduction in six male subjects (25%, 6/24) ranged from 22 to 48 mmHg and the reduction in diastolic blood pressure ranged from 0 to27 mmHg. One of the six subjects needed ammonia salt and leg elevation. Effects on CNS depression and blood pressure (...) Flibanserin Oral Tablet 100 mg Page 4 of 52 ? The need to further evaluate the risk of accidental injury with root cause analysis ? The need to assess the human abuse potential The CR letter recommended that the Applicant conduct one new Phase 3 trial with fewer exclusion criteria to allow enrolment of a broader HSDD population. Given the concerns with content validity of the two FSFI-desire questions and the long recall period (28 days), the letter also stated that the instrument used to assess effects

2015 FDA - Drug Approval Package

16. Osteoarthritis

biomechanics and increase the risk of developing osteoarthritis [ ; ]. Joint laxity and reduced muscle strength — may cause abnormal wear and joint loading [ ; ]. Joint malalignment — history of developmental dysplasia of the hip (DDH); femoroacetabular impingement; leg length discrepancy; varus and valgus knee deformities may all cause abnormal or excess loading of joints [ ; ]. Exercise stresses — may increase joint load, microtrauma, and structural damage, for example, in professional footballers (...) should I suspect a diagnosis of osteoarthritis? Suspect a diagnosis of osteoarthritis if have been excluded and a person is aged 45 years or more, with suggestive clinical features. The clinical features of osteoarthritis are variable, both between people and at different joint sites. Typically, there is a history of: Activity-related joint pain — typically only one or a few joints are affected at any one time, and pain develops over months or years, and No morning joint-related stiffness, or morning

2018 NICE Clinical Knowledge Summaries

17. Neck pain - cervical radiculopathy

occur without evident compression (for example, due to inflammation of the nerve). Cervical radiculopathy is the term used to describe the pain and weakness and/or numbness in one or both of the upper extremities which corresponds to the dermatome of the involved cervical nerve root. It often occurs alongside neck pain which is secondary to compression, or irritation of nerve roots in the cervical spine. The most common causes of cervical radiculopathy are degenerative changes, including cervical (...) occur together. Radicular pain is usually caused by compression of the nerve root due to cervical disc herniation or degenerative spondylotic changes, but radicular symptoms can also occur without evident compression (for example, due to inflammation of the nerve). Cervical radiculopathy is the term used to describe the pain in one or both of the upper extremities which corresponds to the dermatome of the involved cervical nerve root. It often occurs alongside neck pain which is secondary

2018 NICE Clinical Knowledge Summaries

18. Neck pain - non-specific

extension of leg bent at hip and knee) and Brudzinski's sign (reflective flexion of the knees when patient is on his/her back and the neck is bent forwards) to demonstrate nuchal rigidity if meningitis is suspected. Exclude of neck pain. Cervical X-rays, and other imaging studies and investigations are not routinely required. Identify and urgently refer people with indicative of a serious spinal pathology. Grading of neck pain Grading of neck pain Neck pain can be considered in four categories: Grade 1 (...) of sexual, bladder, or bowel function. Hoffman's sign. Incontinence. Lhermitte's sign: flexion of the neck causes an electric shock-type sensation that radiates down the spine and into the limbs. New or severe headache. Photophobia or phonophobia. Visual loss. Weakness involving more than one myotome or loss of sensation involving more than one dermatome. New symptoms before the age of 20 years or after the age of 55 years. Age related factors for people aged under 20 years include: Altered hair

2018 NICE Clinical Knowledge Summaries

19. CRACKCast E043 – Spinal Injuries

Present Intoxication Present Distracting Injury Present 6) Describe incomplete cord lesions 3 major types (account for 90% of incomplete injuries) Central cord syndrome Buckling of ligamentum flavour in patients with degenerative arthritis and hyperextension. Ligamentum flavum contuses the central grey matter. As distal nerve innervate the lower limbs, patients have relative sparing of the legs, however in severe cases only sacral sparing is seen. 50% become ambulatory again Anterior Cord Syndrome (...) Jefferson ( ) Odontoid fracture ( ) Atlanto-occipital dislocation ( ) Wedge Fracture ( ) Large Facet Dislocation ( ) Teardrop Fracture ( ) 4) Describe an approach to C-Spine X-rays, and define normal: Considerations: Predental space Soft-tissue spaces Line of Swischuck STEP ONE: Choose your type 3 main X-rays: Lateral, AP, and odontoid view. Additional view: swimmers view Useful for assessing cervical-thoraco junction (c7 to T1). Oblique view? Flex-EX? Forget it – if your suspicion of a fracture

2016 CandiEM

20. Back Pain ? Child

, Maier J, Dannecker GE. Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr. 2010;169(9):1105- 1111. 18. Bellah RD, Summerville DA, Treves ST, Micheli LJ. Low-back pain in adolescent athletes: detection of stress injury to the pars interarticularis with SPECT. Radiology. 1991;180(2):509-512. 19. Masci L, Pike J, Malara F, Phillips B, Bennell K, Brukner P. Use of the one-legged hyperextension test and magnetic resonance imaging (...) KM. Infective spondylitis in Southern Chinese: a descriptive and comparative study of ninety-one cases. Spine (Phila Pa 1976). 2010;35(6):635-641. 15. Altaf F, Heran MK, Wilson LF. Back pain in children and adolescents. Bone Joint J. 2014;96-B(6):717-723. 16. Summers BN, Singh JP, Manns RA. The radiological reporting of lumbar Scheuermann's disease: an unnecessary source of confusion amongst clinicians and patients. Br J Radiol. 2008;81(965):383-385. 17. Hospach T, Langendoerfer M, von Kalle T

2016 American College of Radiology

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