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Sports Hernia

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81. Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman's hernia (athletic pubalgia). (Abstract)

Laparoscopic surgery for chronic groin pain in athletes is more effective than nonoperative treatment: a randomized clinical trial with magnetic resonance imaging of 60 patients with sportsman's hernia (athletic pubalgia). Chronic groin pain in athletes presents often a diagnostic and therapeutic challenge. Sportsman's hernia (also called "athletic pubalgia") is a deficiency of the posterior wall of the inguinal canal, which is often repaired by laparoscopic mesh placement. Endoscopic mesh (...) repair may offer a faster recovery for athletes with sportsman's hernia than nonoperative therapy.A randomized, prospective study was conducted on 60 patients with a diagnosis of chronic groin pain and suspected sportsman's hernia. Clinical data and MRI were collected on all patients. After 3 to 6 months of groin symptoms, the patients were randomized into an operative or a physiotherapy group (n = 30 patients in each group). Operation was performed using a totally extraperitoneal repair in which

2011 Surgery Controlled trial quality: uncertain

82. Spinal disc herniation

general wear and tear, such as constant sitting or squatting, driving, or a sedentary lifestyle. Herniations can also result from the lifting of heavy loads. [ ] Professional athletes, especially those playing contact sports such as American football, are known to be prone to disc herniations. Within athletic contexts, herniation is often the result of sudden blunt impacts against, or abrupt bending or torsional movements of, the lower back. Pathophysiology [ ] The majority of spinal disc herniations (...) Spinal disc herniation Spinal disc herniation - Wikipedia Spinal disc herniation From Wikipedia, the free encyclopedia "Slipped disc" redirects here. For other uses, see . Spinal disc herniation Other names Slipped disc, ruptured disc, herniated disc, prolapsed disc, herniated nucleus pulposus A spinal disc herniation shown by MRI. , Spinal disc herniation is an injury to the cushioning and connective tissue between , usually caused by excessive strain or trauma to the spine. It may result

2012 Wikipedia

83. Diagnosis and Treatment of Low Back Pain

developed based on a specific definition, inclusion/exclusion criteria, and the re- sulting literature which excluded leg pain below the knee. Leg pain was excluded in order to address treat- ment of nonspecific low back pain. For many sections, the inclusion of leg pain in the literature search would have included many specific causes of back pain, in- cluding disc herniation and spondylolisthesis, that would have made the focus on nonspecific low back pain more difficult and less clear. Without (...) assignments and lack of validated outcome measures. In addition, a number of studies were reviewed sev- eral times in answering different questions within this guideline. How a given question was asked might influence how a study was evaluated and interpreted as to its level of evidence in answering that particular question. For example, a randomized controlled trial reviewed to evaluate the differences between the out- comes of surgically treated versus untreated patients with lumbar disc herniation

2020 North American Spine Society

84. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain

causes of back pain, in- cluding disc herniation and spondylolisthesis, that would have made the focus on nonspecific low back pain more difficult and less clear. Without the inclusion of leg pain, these guideline rec- ommendations address only a subset of low back pain and its care. The inclusion and exclusion criteria used resulted in the removal of multiple articles that may have influenced overall recommendations for a par- ticular treatment or procedure. Evaluation of a par- ticular treatment (...) , a randomized controlled trial reviewed to evaluate the differences between the out- comes of surgically treated versus untreated patients with lumbar disc herniation with radiculopathy might be a well-designed and implemented Level I ther- apeutic study. This same study, however, might be classified as providing Level II prognostic evidence if the data for the untreated controls were extracted and evaluated prognostically. Guideline Development Process Step 1: Recruitment of Guideline Members

2020 American Academy of Pain Medicine

88. Monogenic cerebral small-vessel diseases

childbirth 4.71 100 Antiplatelet and anticoagulant treatments are not recommended in COL4A1/2 cSVD 4.71 100 (continued) 2020 European Academy of Neurology MONOGENIC CEREBRAL SMALL-VESSEL DISEASE RECOMMENDATIONS 5Table 1 (Continued) Query Mean score Percentage of people voting 4or5 Intravenous thrombolysis is not recommended in a patient with a diagnosis of COLA1/2 cSVD 4.71 100 Sporting activities with a high risk of head trauma or excessive or prolonged exercise should be avoided in a patient (...) by age 30– 40 years), gait disturbance, depression, premature head alopecia in 90% of patients during adolescence and severe back pain with lumbar disc herniation are the main clinical features. Additional manifestations include seizures, psychiatric disturbances, pseudobul- bar palsy and spondylosis deformans. The disease is rapidly progressive with stepwise deterioration of motor and cognitive function, and the average illness duration is 20–30 years, although most patients became bedridden within

2020 European Academy of Neurology

89. Abdominal and pelvic imaging

artery stenosis/Renovascular hypertension 31 Renal mass 31 Urinary tract calculi 32 Splenic Indications 33 Splenic mass, benign 33 Splenic mass, indeterminate 33 Splenomegaly 34 Miscellaneous Conditions 34 Hemoperitoneum 34 Hernia 34 Lymphadenopathy 35 Pelvic floor disorders associated with urinary or bowel incontinence 35 Retroperitoneal conditions 35 Sports hernia (athletic pubalgia) 36 Imaging of the Abdomen and Pelvis Copyright © 2020 AIM Specialty Health ® All Rights Reserved. 4 Nonspecific

2020 AIM Specialty Health

90. Overview of musculoskeletal pain

=bestpractice.com Most commonly results from motor vehicle accidents, gunshot or stab wounds, contact sports, or workplace accidents during heavy physical labour. The effects of the injury include paralysis, loss of sensation, and pain. The specific clinical presentation will depend on the nerve roots involved and the degree of injury to each root. A bursa is a sac containing a small amount of synovial fluid that lies between a tendon and either skin or bone to act as a friction buffer. In bursitis (...) the injury. Pain from these disorders can persist and cause work disabilities if left unchecked, and without secondary prevention strategies in place. Overuse syndrome of the paediatric population, which results in traction apophysitis of the tibial tubercle. Typically occurs during an adolescent growth spurt in young athletes who participate in sports that involve repeated knee flexion and forced extension. Males are affected more often than females. Diagnosis is clinical; patients typically present

2018 BMJ Best Practice

91. Overview of occupational overuse syndromes

NM, Nouvong A. The top 10 things foot and ankle specialists wish every primary care physician knew. Mayo Clin Proc. 2006;81:818-822. http://www.mayoclinicproceedings.org/article/S0025-6196%2811%2961736-9/fulltext http://www.ncbi.nlm.nih.gov/pubmed/16770982?tool=bestpractice.com Irving DB, Cook JL, Menz HB. Factors associated with chronic plantar heel pain: a systematic review. J Sci Med Sport. 2006;9:11-22. http://www.ncbi.nlm.nih.gov/pubmed/16584917?tool=bestpractice.com Heavy lifting does (...) not predispose to hernia formation, but rather brings the hernia to the attention of the patient. Any occupation that causes repetitive mechanical stress over a bursa may result in bursitis. In primary care, bursitis most commonly presents in the knee, and as subacromial (subdeltoid), trochanteric, retrocalcaneal, and olecranon bursae. Jackhammer operation and other causes of vibration injury increase the risk of developing secondary Raynaud's phenomenon. Tendon degeneration characterised by a combination

2018 BMJ Best Practice

92. The impact of workers' compensation on outcomes of surgical and nonoperative therapy for patients with a lumbar disc herniation: SPORT. Full Text available with Trip Pro

The impact of workers' compensation on outcomes of surgical and nonoperative therapy for patients with a lumbar disc herniation: SPORT. Prospective randomized and observational cohorts.To compare outcomes of patients with and without workers' compensation who had surgical and nonoperative treatment for a lumbar intervertebral disc herniation (IDH).Few studies have examined the association between worker's compensation and outcomes of surgical and nonoperative treatment.Patients with at least 6

2010 Spine Controlled trial quality: uncertain

93. In adults with neural leg pain (sciatica), is a cauda epidural as effective as physiotherapy in reducing pain, return to work and restoring function?

informed treatment choices. Search timeframe: Initial Search 2005-2015 Updated search 2006-2016 Inclusion Criteria Description Search terms (In the final document this should be a combination of your clinical and librarian search terms) Population and Setting Adults with neural leg pain (sciatica) Adults, leg pain, sciatica, spinal stenosis, arthritis, disc herniation, spondylosis, spondylitis, nerve root pain, acute, chronic Intervention or Exposure Caudal epidural injection Caudal, epidural (...) completed: Aug 2015 l.huckfield@keele.ac.uk 2 effectiveness Types of studies National clinical practice guidelines, systematic reviews, meta- analysis, RCTs Routine Databases Searched Clinical Knowledge Summaries, PEDro, BMJ Updates, Clinical Evidence, TRIP, Database,NICE,HTA,Bandolier,The,CochraneLibrary,Medline,Cinahl,Embase,PsycInfo, Professional websites. Joanna Briggs Institute, Web of science, Sports discus and Pub med Results of the searches: Initial search 2015 Results of updated search -08/09

2018 Public Health England

94. Updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension Full Text available with Trip Pro

, Italy, Pakistan, Sweden, Switzerland, the United Kingdom, and the United States of America. The EWG consisted of 22 pediatricians (with expertise and board certifications in pediatric cardiology, critical care, pulmonology, neonatology, sports medicine, and/or genetics), 7 doctors with sub-specialty certifications for adults with CHD (3 adult cardiology, 4 pediatric cardiology), 1 adult pulmonologist, and 1 thoracic transplant surgeon. Special features of the 2019 guidelines on pediatric PH

2019 International Society for Heart and Lung Transplantation

97. AIM Clinical Appropriateness Guidelines for Spine Surgery

- for nerve root decompression in cases of soft posterolateral disc herniation or bony foraminal stenosis ? Posterior laminectomy with or without fusion - for congenital stenosis, multilevel central stenosis from spondylosis, or multiple discontinuous levels where fusion is recommended to prevent kyphotic deformity. Note that a regional kyphosis (greater than 13 degrees) has been associated with unfavorable outcomes following posterior-only surgery ? Posterior laminoplasty - osteoplastic enlargement (...) on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone. J Neurosurg Spine. 2017;26(1):19-27. 4 Gebremariam L, Koes BW, Peul WC, et al. Evaluation of treatment effectiveness for the herniated cervical disc: a systematic review. Spine. 2012;37(2):E109-18. 5 Kadanka Z, Bednarik J, Novotny O. Cervical spondylotic myelopathy: conservative versus surgical treatment after 10 years. Eur Spine J. 2011;20(9):1533-8. 6 Lebl DR, Bono CM. Update

2019 AIM Specialty Health

98. Spine imaging

evaluation. Contrast MRI may also be useful for imaging herniated discs—particularly if herniation needs to be distinguished from post-surgical epidural scarring—and diagnosing tumors in the intramedullary, extramedullary, and extradural spaces. Contraindications to MRI may include implanted devices unsafe for use in an MRI scanner—such as pacemakers or implantable cardioverter-defibrillators—and claustrophobia. CT discography determines the available volume of discs and can be used to localize annulus (...) fibrosis fissures or herniated discs. Discography can also confirm the source of back pain by reproducing the symptoms associated with disc herniation. MR discography may be performed in the event that CT is contraindicated. False positives, infection, and neural injury are possible with discography, and it should be used primarily to confirm an initial diagnosis. Definitions Phases of the care continuum are broadly defined as follows: ? Screening – testing in the absence of signs or symptoms

2019 AIM Specialty Health

99. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

Lymphadenopathy 29 Pelvic floor disorders associated with urinary or bowel incontinence 29 Prostate cancer 29 Retroperitoneal conditions 30 Splenic hematoma 30 Splenomegaly 30 Sports hernia (athletic pubalgia) 30 Undescended testicle (cryptorchidism) 31 Imaging of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 4 Nonspecific Signs and Symptoms 31 Abdominal pain 31 Azotemia 32 Lower extremity edema 32 Fever of unknown origin 32 Pelvic pain 32 Weight loss 33 Exclusions 33 (...) ) 22 Osseous tumor 22 Osteoid osteoma 23 Osteomyelitis 23 Pelvic fracture 23 Sacroiliitis 24 Septic arthritis 24 Pancreatic Indications 24 Pancreatic mass 24 Pancreatic pseudocyst 24 Pancreatitis 24 Renal & Urinary Tract Indications 25 Bladder or urethral diverticula 25 Hematuria 25 Hydronephrosis 26 Nephrocalcinosis 26 Polycystic kidney disease 26 Pyelonephritis 26 Renal mass 26 Urinary tract calculi 27 Miscellaneous Conditions 28 Adrenal hemorrhage 28 Adrenal mass 28 Hemoperitoneum 28 Hernia 29

2019 AIM Specialty Health

100. Suspected Spine Trauma ? Child

for the classification of thoracolumbar fractures [97]. MRI Thoracic and Lumbar Spine MRI of the spine may be of value as a follow-up examination in patients who have an abnormal neurological examination. MRI without IV contrast has become the modality of choice for imaging of children with thoracolumbar trauma and is especially useful in detecting injuries that require surgical intervention and that may be missed on CT, such as epidural hematoma or traumatic disk herniation [93]. SCIWORA is more common in children (...) . Pediatric cervical spine trauma imaging: a practical approach. Pediatr Radiol 2009;39:447-56. 10. Pang D, Wilberger JE, Jr. Spinal cord injury without radiographic abnormalities in children. J Neurosurg 1982;57:114-29. 11. Babcock L, Olsen CS, Jaffe DM, Leonard JC, Cervical Spine Study Group for the Pediatric Emergency Care Applied Research N. Cervical Spine Injuries in Children Associated With Sports and Recreational Activities. Pediatr Emerg Care 2016. 12. Adelgais KM, Browne L, Holsti M, Metzger RR

2019 American College of Radiology

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