BACKGROUND & AIMS: :Based on a review of the literature and his clinical experience, the author reviews the etiology of musculoskeletal disorders of instrumental musicians. A discussion follows which compares and contrasts these problems with those of athletes, and a general strategy for the rehabilitation of musicians with musculoskeletal disorders is presented. J Orthop Sports Phys Ther 1986;8(6):285-297.

背景与目标： ：基于对文献和他的临床经验的回顾，作者回顾了器乐音乐家的肌肉骨骼疾病的病因。随后的讨论将这些问题与运动员的问题进行了比较和对比，并提出了患有肌肉骨骼疾病的音乐家康复的一般策略。 J Orthop运动物理学杂志1986; 8（6）：285-297。

BACKGROUND & AIMS: :Wound irrigation to remove debris and lessen bacterial contamination is an essential component of open fracture care. However, considerable practice variation exists in the details of technique. Volume is an important factor; increased volume improves wound cleansing to a point, but the optimal volume is unknown. High-pressure flow has been shown to remove more bacteria and debris and to lower the rate of wound infection compared with low-pressure irrigation, although recent in vitro and animal studies suggest that it may also damage bone. Pulsatile flow has not been demonstrated to increase efficacy. Antiseptic additives can kill bacteria in the wound, but host-tissue toxicities limit their use. Animal and clinical studies of the use of antiseptics in contaminated wounds have yielded conflicting outcomes. Antibiotic irrigation has been effective in experimental studies in some types of animal wounds, but human clinical data are unconvincing due to poor study design. There are few animal or clinical studies of musculoskeletal wounds. Detergent irrigation aims to remove, rather than kill, bacteria and has shown promise in animal models of the complex contaminated musculoskeletal wound.

背景与目标： ：伤口冲洗以清除碎屑并减少细菌污染是开放式骨折护理的重要组成部分。但是，在技术细节上存在很大的实践差异。体积是重要因素；增加的体积可以使伤口清洁达到一定程度，但是最佳体积尚不清楚。与最近的体外和动物研究表明，高压流比低压灌流能清除更多细菌和碎片，并降低伤口感染率，尽管最近的体外和动物研究表明，高压流也可能损害骨骼。脉搏血流尚未被证明能提高疗效。防腐添加剂可以杀死伤口中的细菌，但是宿主组织的毒性限制了它们的使用。在污染的伤口中使用抗菌剂的动物和临床研究得出了相互矛盾的结果。抗生素冲洗在某些类型的动物伤口的实验研究中已经很有效，但是由于不良的研究设计，人类的临床数据令人信服。肌肉骨骼伤口的动物或临床研究很少。洗涤剂灌溉旨在去除而不是杀死细菌，并且在复杂污染的肌肉骨骼伤口的动物模型中显示出了希望。

BACKGROUND & AIMS: OBJECTIVE:Information about the pre-diagnosis period in psoriatic arthritis (PsA) is limited. We compared health care utilization related to musculoskeletal issues during a 5-year period prior to the diagnosis of PsA versus subjects with no prior inflammatory arthritis within a primary care setting. METHODS:We conducted a population-based, matched cohort study using electronic medical records and administrative data in Ontario, Canada. Age- and sex-matched cohorts of PsA patients and comparators from the same family physicians were assembled. Comparators were not allowed to have prior spondyloarthritis, ankylosing spondylitis, or rheumatoid arthritis billing code diagnoses. The study outcomes included health care utilization and costs related to non-specific musculoskeletal issues during a 5-year period prior to the index date. RESULTS:We studied 462 PsA patients and 2310 matched comparators. The odds ratio (OR) related to visiting a primary care physician for nonspecific musculoskeletal issues in patients with PsA was 2.14 (95% CI 1.73, 2.64) in the year immediately preceding the index date and was similarly elevated up to 5 years prior. The OR related to using other musculoskeletal-related health care services, including musculoskeletal specialists visits, joint injections, joint imaging, and emergency department visits, were higher in PsA as early as 5 years preceding the index date. Total and musculoskeletal-related healthcare costs prior to the index date were higher in patients with PsA versus comparators. CONCLUSION:A prodromal PsA phase, characterized by non-specific musculoskeletal symptoms may exist. Further study is needed to determine if this represents a window for earlier diagnosis of PsA.

背景与目标： 目的：有关银屑病关节炎（PsA）的诊断前期的信息有限。我们比较了在诊断PsA之前的5年内与肌肉骨骼问题相关的医疗保健利用率与在初级保健机构中既往没有炎性关节炎的受试者的比较。
方法：我们在加拿大安大略省使用电子病历和行政数据进行了一项基于人群的配对队列研究。收集了年龄和性别相匹配的PsA患者和来自同一家庭医生的比较者的队列。比较者不得事先患有脊椎关节炎，强直性脊柱炎或类风湿关节炎，按帐单代码进行诊断。研究结果包括在索引日期之前的5年内的医疗保健利用率以及与非特异性肌肉骨骼问题相关的费用。
结果：我们研究了462名PsA患者和2310名匹配的比较者。在就诊日期之前的一年中，与就PsA患者的非特异性肌肉骨骼问题就诊的初级保健医生有关的比值比（OR）为2.14（95％CI 1.73，2.64），并且在5年之前也有所提高。早在索引日期之前的5年，与使用其他与骨骼肌肉相关的医疗保健服务（包括骨骼肌肉专家的就诊，联合注射，联合影像学和急诊科就诊）相关的OR值在PsA中较高。 PsA患者在索引日期之前的总和与肌肉骨骼相关的医疗保健费用要高于比较者。
结论：可能存在以非特异性肌肉骨骼症状为特征的前驱性PsA期。需要进一步研究以确定这是否代表早期诊断PsA的窗口。

BACKGROUND & AIMS: BACKGROUND:Within work sociology, several studies have addressed construction workers' practices of masculinity, class, economy, safety risks and production. However, few studies have investigated room for agency in relation to bodily pain or musculoskeletal disorders and even fewer have made a quantitative approach. Accordingly, by means of a questionnaire, we examined the association between construction workers' room for agency and physical exertion, bodily and mental fatigue, and lower back pain. METHODS:A total of 481 Danish construction workers who responded to a multifaceted questionnaire were included. Drawing on previous studies and a Foucauldian inspired concept of agency, agency was quantified through specially crafted questions and examined in relation to established measures on physical exertion, physical and mental fatigue and pain in the lower back. Associations were tested using analyses of variance (general linear models) and controlled for age, gender, job group, lifestyle and depression. RESULTS:When asked about options for agency reducing the burden of work, few workers believed themselves to be prime agents of such practices. When asking about their view on performing alternative agency implying caring for the body, 39-49% expected negative reactions from management, and 20-33% expected negative reactions from colleagues. In contrast, only 13-18% of the participants stated that they would give a negative reception to such alternative practices. Using the expected reception outcomes (positive, neutral, negative) to alternative practices as predictors, the statistical regression analyses showed that negative expectations to management were associated with higher levels of physical exertion 0.62 (95% CI = 0.14-1.09) (scale 0-11), bodily fatigue 0.63 (95% CI = 0.22-1.04), mental fatigue 0.60 (95% CI = 0.07-1.12), and low back pain 0.79 (95% CI = 0.13-1.46) (scales 0-10). CONCLUSION:In our study, construction workers answered questions about work and MSD. The answers indicated a contradiction between perceived responsibility and room for agency. Based on the study, a number of target areas could fruitfully be addressed in aiming to reduce MSD among construction workers. To change workers' expectances to the reception of lowering work pace if needed to take care of the body, their expectances to the reception of sickness absence as a result of pain, of discussing physical exertion in work and of demanding appropriate technical assistive devices are such examples. Our results emphasize that management plays an important role in this.

背景与目标： 背景：在工作社会学领域，多项研究针对建筑工人的男性气质，阶级，经济，安全风险和生产实践。然而，很少有研究调查与身体疼痛或肌肉骨骼疾病有关的代理空间，很少有研究采用定量方法。因此，我们通过问卷调查了建筑工人的体力活动空间与体力消耗，身体和精神疲劳以及下背部疼痛之间的关系。
方法：总共包括481名丹麦建筑工人，他们回答了多方面的问卷。借鉴先前的研究和受富高卢启发的代理概念，通过特制的问题对代理进行了量化，并与确定的有关下肢身体劳累，身心疲劳和疼痛的措施进行了比较。使用方差分析（一般线性模型）对关联进行了测试，并针对年龄，性别，工作组，生活方式和抑郁进行了控制。
结果：当被问及减轻工作负担的机构选择时，很少有工人认为自己是这种做法的主要推动者。当问及他们对执行替代机构意味着对身体的关怀的看法时，有39-49％的人预期管理层会产生负面反应，而有20-33％的人预期会受到同事的负面反应。相反，只有13-18％的参与者表示，他们会对这种替代做法持否定态度。使用替代疗法的预期接受结果（阳性，中性，阴性）作为预测指标，统计回归分析表明，对管理人员的负面期望与较高的体力消耗水平相关（0.62（95％CI = 0.14-1.09））（等级0- 11），身体疲劳0.63（95％CI == 0.2-1.04），精神疲劳0.60（95％CI = 0.07-1.12）和下背部疼痛0.79（95％CI = 0.13-1.46）（0-10分）。
结论：在我们的研究中，建筑工人回答了有关工作和MSD的问题。答案表明，责任感与代理权之间存在矛盾。根据这项研究，可以有效地解决许多目标领域，以减少建筑工人的MSD。如果需要照顾身体，要改变工人对降低工作节奏的期望，他们对因疼痛而导致疾病缺席的期望，讨论工作中的体力劳动以及要求适当的技术辅助装置的期望就这样改变了。例子。我们的结果强调，管理在其中起着重要作用。

BACKGROUND & AIMS: BACKGROUND/OBJECTIVE:Chronic knee pain (CKP) is a common pain complaint in older adults that is often associated with disability. This study investigated the relationship between 2 components of subjective well-being (depressive symptoms and life satisfaction) and CKP phenotypes based on the presence of knee disability. METHODS:A cross-sectional study was performed at baseline of ELSA-Brasil Musculoskeletal cohort (2012-2014). Chronic knee pain phenotypes were identified according to the presence of CKP that was accompanied or not by disability, which was assessed by a question on pain-related limitations to perform everyday activities (overall), Western Ontario and McMaster Universities Osteoarthritis Index's physical function subscale (daily tasks) and 5-times sit-to-stand test (objective). Depressive symptoms were assessed by the Clinical Interview Schedule-Revised and life satisfaction by the Satisfaction With Life Scale. Multinomial logistic regressions used CKP phenotypes as response variables (no CKP as reference). RESULTS:The sample comprised 2898 participants (mean age, 55.9 ± 8.9 years; 52.9% were female). After adjustments for sociodemographic and clinical factors, depressive symptoms were associated with daily tasks disabling CKP (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.45-3.66) and objective disabling CKP (OR, 1.95; 95% CI, 1.29-2.93) and with nondisabling CKP for the overall disability measure (OR, 1.54; 95% CI, 1.17-2.04). Life satisfaction was inversely associated with all phenotypes in fully adjusted models, with strongest magnitude of associations observed for disabling CKP. CONCLUSIONS:Associations of depressive symptoms and life satisfaction with CKP phenotypes suggest the need to address both negative and positive components of subjective well-being in the assessment of individuals with knee complaints.

背景与目标： 背景/目的：慢性膝关节疼痛（CKP）是老年人常见的疼痛症状，通常与残疾有关。这项研究基于膝关节残疾的存在，调查了主观幸福感的两个组成部分（抑郁症状和生活满意度）与CKP表型之间的关系。
方法：在ELSA-巴西肌肉骨骼队列（2012-2014）的基线进行了横断面研究。根据是否伴有或未伴有残疾的CKP来确定慢性膝关节疼痛表型，该评估通过对与疼痛相关的限制进行日常活动（总体），西安大略和麦克马斯特大学骨关节炎指数的身体机能分量表进行评估（日常任务）和5次静坐测试（客观）。抑郁症状通过临床访谈时间表修订版进行评估，生活满意度通过生活满意度量表进行评估。多项逻辑回归使用CKP表型作为响应变量（无CKP作为参考）。
结果：该样本包括2898名参与者（平均年龄，55.9±8.9岁； 52.9％为女性）。调整了社会人口统计学和临床​​因素后，抑郁症状与禁用CKP的日常任务相关（优势比[OR]为2.30； 95％置信区间[CI]为1.45-3.66）和客观禁用CKP的患者（OR为1.95； 95％CI） ，则为1.29-2.93），并且使用非禁用CKP进行总体残疾评估（OR为1.54； 95％CI为1.17-2.04）。在完全调整的模型中，生活满意度与所有表型均呈反比关系，其中观察到的最大程度的关联性是使CKP丧失能力。
结论：抑郁症状和生活满意度与CKP表型的相关性表明，在评估膝关节不适患者时，有必要解决主观幸福感的消极和积极因素。

BACKGROUND & AIMS: BACKGROUND CONTEXT:A potential correlation between surgery for symptomatic adjacent segment degeneration (sASD) and the development of degenerative disease of the lumbar spine or osteoarthritis of the musculoskeletal joints remains to be determined. PURPOSE:To assess the rate of sASD following anterior cervical discectomy and fusion (ACDF), the rate of lumbar discectomy (LD), and rate of surgery performed for osteoarthritis at the joints of the musculoskeletal in a long term follow-up. STUDY DESIGN/SETTING:Cohort study OUTCOME MEASURES: Repeat procedure for sASD, microsurgical LD (MSD), and/or the musculoskeletal joints (shoulder, knee, hip). PATIENT SAMPLE:Retrospectively, a total of 833 consecutive patients who underwent ACDF for degenerative disorders ≥20 years ago were identified. Charts were reviewed for preoperative neurological status, smoking status, physical labor, and repeat procedures. Missing data lead to exclusion from follow-up assessment. METHODS:At final follow-up the need for pain medication, Neck disability index (NDI), and Odoms criteria were evaluated. An MRI was performed to assess the grade of degeneration of the cervical spine via the segmental degeneration index (SDI). Patients without (group 1) and with (group 2) repeat procedure for sASD were compared. RESULTS:Collectively, 313 patients met inclusion criteria and 136 patients were evaluated. The mean follow-up was 26 years. Clinical success rate according to Odoms was 85.3%, mean NDI was 14.4%, the rate of regular intake of pain medication was 14.7%, the rate of repeated procedure for sASD was 10.3%. MSD was performed in 23.5%, surgery for osteoarthritis of the shoulder, the hip, and the knee were performed in 11.8%, 6.9%, and 27.7%, respectively. The rate of MSD (p=.018) was significantly higher in group 2 compared to group 1. Gender, smoking status, surgery of the musculoskeletal joints, and the grade of degeneration of the cranial and caudal adjacent segments were similar between group 1 and group 2. CONCLUSION:The overall clinical success following ACDF was 85.3%. The rate of repeat procedure for sASD was 10.3% within 26 years. Patients with sASD had a significantly higher rate of MSD and poorer clinical outcome compared to patients without sASD.

背景与目标： 背景技术：有症状的邻近节段性变性（sASD）手术与腰椎退行性疾病或肌肉骨骼关节骨关节炎发展之间的潜在相关性尚待确定。
目的：评估长期随访中颈椎前路椎间盘切除术和融合术（ACDF）后sASD的发生率，腰椎间盘切除术（LD）的发生率以及肌肉骨骼关节骨关节炎的手术率。
研究设计/设置：队列研究结果指标：对sASD，显微外科手术LD（MSD）和/或肌肉骨骼关节（肩，膝，髋）重复操作。
病人样本：回顾性地，共鉴定出833例接受ACDF≥20年前的变性疾病的连续患者。复查图表以了解术前神经系统状况，吸烟状况，体力劳动和重复手术。缺少数据导致无法进行后续评估。
方法：在最后的随访中，评估了止痛药的需求，颈部残疾指数（NDI）和Odoms标准。进行了MRI，以通过节段性变性指数（SDI）评估颈椎变性的程度。比较了没有（第1组）和有（第2组）重复进行sASD的患者。
结果：共有313例患者符合入选标准，对136例患者进行了评估。平均随访时间为26年。根据Odoms的临床成功率为85.3％，平均NDI为14.4％，常规服用止痛药的比率为14.7％，重复进行sASD的比率为10.3％。 MSD手术率为23.5％，肩部，髋部和膝盖骨关节炎的手术率分别为11.8％，6.9％和27.7％。与第1组相比，第2组的MSD发生率（p = .018）明显更高。第1组和第2组之间的性别，吸烟状况，肌肉骨骼关节手术以及颅骨和尾端相邻节段的退化程度相似。第二组
结论：ACDF术后总的临床成功率为85.3％。 sASD的重复手术率在26年内为10.3％。与没有sASD的患者相比，患有sASD的患者的MSD发生率明显更高，而临床结局也较差。

BACKGROUND & AIMS: :Coronavirus disease 2019 (COVID-19) is an emerging pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the majority of patients who become infected with SARS-CoV-2 are asymptomatic or have mild symptoms, some patients develop severe symptoms that can permanently detract from their quality of life. SARS-CoV-2 is closely related to SARS-CoV-1, which causes severe acute respiratory syndrome (SARS). Both viruses infect the respiratory system, and there are direct and indirect effects of this infection on multiple organ systems, including the musculoskeletal system. Epidemiological data from the SARS pandemic of 2002 to 2004 identified myalgias, muscle dysfunction, osteoporosis, and osteonecrosis as common sequelae in patients with moderate and severe forms of this disease. Early studies have indicated that there is also considerable musculoskeletal dysfunction in some patients with COVID-19, although long-term follow-up studies have not yet been conducted. The purpose of this article was to summarize the known musculoskeletal pathologies in patients with SARS or COVID-19 and to combine this with computational modeling and biochemical signaling studies to predict musculoskeletal cellular targets and long-term consequences of the SARS-CoV-2 infection.

背景与目标： ：冠状病毒病2019（COVID-19）是由严重的急性呼吸系统综合症冠状病毒2（SARS-CoV-2）引起的新兴大流行性疾病。尽管大多数感染SARS-CoV-2的患者无症状或症状较轻，但有些患者出现严重症状，可能永久性地降低其生活质量。 SARS-CoV-2与SARS-CoV-1密切相关，后者会导致严重的急性呼吸道综合症（SARS）。两种病毒都感染呼吸系统，并且这种感染对包括肌肉骨骼系统在内的多个器官系统都有直接或间接的影响。 2002年至2004年SARS大流行的流行病学数据将肌痛，肌肉功能障碍，骨质疏松和骨坏死定为中度和重度形式的该病患者的常见后遗症。早期研究表明，尽管尚未进行长期随访研究，但某些COVID-19患者也存在相当大的肌肉骨骼功能障碍。本文的目的是总结SARS或COVID-19患者的已知肌肉骨骼病理，并将其与计算模型和生化信号研究相结合，以预测肌肉骨骼细胞靶标和SARS-CoV-2感染的长期后果。

BACKGROUND & AIMS: PURPOSE:To investigate the prevalence of musculoskeletal symptoms, defined as aches, pains, discomfort, or numbness, by using a validated assessment tool among interventional radiologists. MATERIALS AND METHODS:A Web-based survey using the Nordic Musculoskeletal Questionnaire was disseminated to interventional radiologist members by email in November 2015. Musculoskeletal symptoms were evaluated in 9 body areas. Information regarding participant demographics, practice details, use of radio-protective equipment, and exercise routines was also gathered. Univariate and multivariate analyses were performed to determine risk factors associated with more severe symptoms. RESULTS:Of 4,096 SIR members at the time of the survey, 640 completed the questionnaire in its entirety (16% response rate). Respondents consisted of 69 females (11%) and 571 males (89%), with a mean age of 47.5 ± 10.2 years old, a mean body mass index of 25.5 ± 3.9 kg/m2, and a mean practice length of 17.1 ± 9.8 years. Prevalence of musculoskeletal symptoms was 88% in the 12 months preceding the survey. For those reporting musculoskeletal issues, 58% attributed the symptoms to work-related activities. Lower back (61%), neck (56%), and shoulder complaints (46%) were the most common. Symptoms prevented 21.2% of respondents from being able to work over the same time period. Multivariate analysis identified female gender, above-normal body mass index, and a practice length of 10 years or more as factors associated with a higher risk of moderate-to-severe symptoms. CONCLUSIONS:Musculoskeletal symptoms are prevalent among interventional radiologists, the majority of which are attributed to work-related causes.

背景与目标： 目的：通过在放射介入医师中使用经过验证的评估工具，调查肌肉骨骼症状（定义为疼痛，疼痛，不适或麻木）的患病率。
材料与方法：2015年11月，通过电子邮件将基于北欧肌肉骨骼问卷的网络调查通过电子邮件散发给介入放射科医生。对9个身体部位的骨骼骨骼症状进行了评估。还收集了有关参与者的人口统计信息，练习细节，使用无线电防护设备以及锻炼程序的信息。进行单因素和多因素分析以确定与更严重症状相关的危险因素。
结果：在调查时有4,096名SIR成员中，有640名完成了调查问卷（答复率为16％）。受访者包括69位女性（11％）和571位男性（89％），平均年龄为47.5±10.2岁，平均体重指数为25.5±3.9 kg / m2，平均练习时长为17.1±9.8年。在调查前的12个月内，肌肉骨骼症状的患病率为88％。对于那些报告肌肉骨骼问题的人，有58％将症状归因于与工作有关的活动。下背部（61％），颈部（56％）和肩部不适（46％）是最常见的。症状使21.2％的受访者无法在同一时间工作。多变量分析确定女性性别，高于正常的体重指数和10年或更长时间的练习时长是与中度至重度症状的较高风险相关的因素。
结论：介入放射科医师中普遍存在肌肉骨骼症状，其中大部分是与工作有关的原因。

BACKGROUND & AIMS: :There is increasing concern about the emerging global non-communicable diseases (NCDs) burden. The focus has mainly been on NCDs in adults but it is important that MSK morbidity in both children and adults is included in strategic planning. There have been considerable advances in the understanding and treatment options for children and young people (CYP) and clinical outcomes are improving for those who can access such high quality care. However vast inequity exists and there are many CYP who live in areas of the world with high burden of health care challenges, compounded by paucity of specialist care and limited access to treatments. The Paediatric Global Musculoskeletal Task Force aims to raise awareness about unmet needs for CYP with MSK conditions, promotion of MSK health through lifestyle and the avoidance of injury. We aim to leverage change through 'working together better'.

背景与目标： ：人们越来越关注新兴的全球非传染性疾病（NCD）负担。重点主要放在成年人的非传染性疾病上，但重要的是将儿童和成年人的MSK发病率纳入战略规划中。对于儿童和年轻人（CYP）的理解和治疗选择已经有了长足的进步，并且对于那些可以获得这种高质量护理的人来说，临床结果正在改善。但是，存在着巨大的不平等现象，世界上有许多CYP居住在医疗保健挑战众多的地区，而专科护理的匮乏和获得治疗的机会也很有限。儿科全球肌肉骨骼工作队旨在提高人们对未满足MSP条件的CYP需求的认识，通过生活方式和避免伤害来促进MSK健康。我们的目标是通过“更好地合作”来利用变化。

BACKGROUND & AIMS: INTRODUCTION:It is well known that foot massage is a very prevalent stress relief method in China. Literatures have reported various massage-inducted peripheral nerve injuries. However, massage-inducted lateral plantar nerve (LPN) injury is very rare. Here, we represent an unusual case of massage-inducted LPN damage, and we also report the diagnostic method of this patient using musculoskeletal ultrasonography combined with electromyography (EMG). PATIENT CONCERNS:A 21-year-old woman presented symptoms of redness, swelling, pain and numbness in the medial right ankle joint for 2 days. DIAGNOSIS:The results of musculoskeletal ultrasonography and EMG provide great help for doctors to make accurate diagnosis. The patient was eventually diagnosed with LPN injury. INTERVENTIONS:No further foot massage was allowed. Vitamin B12 was taken orally for 2 months. Conservative therapy, including electrical stimulation therapy and infrared therapy, was conducted. Besides, active rehabilitation training was also performed. OUTCOMES:The discomfort symptoms were relieved significantly after 2 months conservative treatment. Clinical symptoms and EMG examination illustrated satisfactory result during follow up time. CONCLUSION:The report showed that the masseur should be very careful when doing foot massage to prevent nerve damage. Besides, musculoskeletal ultrasonography combined with EMG can provide important evidence for accurate and effective diagnosis of LPN injury.

背景与目标： 简介：众所周知，足部按摩在中国是一种非常普遍的缓解压力的方法。文献报道了各种按摩引起的周围神经损伤。然而，按摩引起的足底外侧神经（LPN）损伤非常罕见。在这里，我们代表了按摩引起的LPN损伤的罕见情况，我们还报告了使用肌肉骨骼超声检查结合肌电图检查（EMG）对该患者的诊断方法。
患者担忧：一名21岁的女性在右踝内侧关节出现发红，肿胀，疼痛和麻木的症状，持续了2天。
诊断：肌肉骨骼超声检查和肌电图检查的结果为医生进行准确的诊断提供了很大的帮助。该患者最终被诊断出患有LPN损伤。
干预措施：不允许进一步的足部按摩。口服维生素B12，持续2个月。进行了保守疗法，包括电刺激疗法和红外线疗法。此外，还进行了积极的康复训练。
结果：保守治疗2个月后，不适症状明显缓解。临床症状和肌电图检查显示随访期间结果令人满意。
结论：该报告表明，按摩师在进行足部按摩时应非常小心，以防止神经损伤。此外，肌肉骨骼超声检查结合肌电图检查可为准确，有效地诊断LPN损伤提供重要依据。

BACKGROUND & AIMS: BACKGROUND:Evidence points to clinicians' beliefs and practice behaviours related to low back pain (LBP), which are discordant with contemporary evidence. While interventions to align beliefs and behaviours with evidence among clinicians have demonstrated effectiveness, a more sustainable and cost-effective approach to positively developing workforce capacity in this area may be to target the emerging workforce. The aim of this study was to investigate beliefs and clinical recommendations for LBP, and their alignment to evidence, in Australian university allied health and medical students. METHODS:Final-year students in chiropractic, medicine, occupational therapy, pharmacy and physiotherapy disciplines in three Western Australian universities responded to a survey. Demographic data, LBP-related beliefs data [modified Health Care Providers Pain and Impact Relationship Scale (HC-PAIRS) and the Back Pain Beliefs Questionnaire (BBQ)] and activity, rest and work clinical recommendations for an acute LBP clinical vignette were collected. RESULTS:Six hundred two students completed the survey (response rate 74.6%). Cross-discipline differences in beliefs and clinical recommendations were observed (p > 0.001). Physiotherapy and chiropractic students reported significantly more helpful beliefs compared with the other disciplines, while pharmacy students reported the least helpful beliefs. A greater proportion of chiropractic and physiotherapy students reported guideline-consistent recommendations compared with other disciplines. HC-PAIRS and BBQ scores were strongly associated with clinical recommendations, independent to the discipline of study and prior experience of LBP. CONCLUSIONS:Aligning cross-discipline university curricula with current evidence may provide an opportunity to facilitate translation of this evidence into practice with a focus on a consistent, cross-discipline approach to LBP management.

背景与目标： 背景：证据表明临床医生的信念和与下腰痛（LBP）有关的行为，与现代证据不符。尽管在临床医生中采取干预措施使信念和行为与证据保持一致的做法已证明是有效的，但积极地发展该领域劳动力能力的更具可持续性和成本效益的方法可能是针对新兴劳动力。这项研究的目的是调查澳大利亚大学相关健康和医学专业学生对LBP的信念和临床建议，以及它们与证据的一致性。
方法：西澳大利亚州三所大学的脊骨疗法，医学，职业治疗，药学和物理疗法学科的大四学生对此进行了调查。收集了人口统计学数据，与LBP相关的信念数据[经修改的卫生保健提供者疼痛和影响关系量表（HC-PAIRS）和腰痛信念问卷（BBQ）]以及针对急性LBP临床小插图的活动，休息和工作的临床建议。
结果：602名学生完成了调查（回答率为74.6％）。观察到信念和临床建议的跨学科差异（p> 0.001）。与其他学科相比，理疗和脊骨疗法学生报告的帮助信念明显要多，而药学专业的学生报告的帮助信念最少。与其他学科相比，脊椎治疗和物理治疗学生中有更大比例的人报告了指南一致的建议。 HC-PAIRS和BBQ评分与临床建议密切相关，而与研究学科和LBP的既往经验无关。
结论：使跨学科的大学课程与当前的证据保持一致，可能会提供一个机会，以侧重于一致，跨学科的LBP管理方法为重点，将这一证据转化为实践。

BACKGROUND & AIMS: OBJECTIVES:The primary objective of the present study was to examine the role of sex as a moderator of the relation between depression and activity-related pain. METHODS:The study sample consisted of 83 participants (42 women, 41 men) with musculoskeletal conditions. Participants were asked to lift a series of 18 canisters that varied in weight (2.9 kg, 3.4 kg and 3.9 kg) and distance from the body. Participants were asked to rate their pain while they lifted each canister and estimate the weight of the canisters. RESULTS:Consistent with previous research, the relations among depression, pain intensity and disability were stronger for women than for men. ANOVA revealed that depression was associated with more intense activity-related pain in women only. For both women and men, the intensity of pain increased with each trial, although the weight of the objects lifted remained constant. Neither sex nor depression had an effect on participants' weight estimates. CONCLUSIONS:The present discussion addresses the mechanisms through which depression may differentially affect pain in women and men. It also addresses the potential clinical implications of pain-augmenting effects of depression in women.

背景与目标： 目的：本研究的主要目的是检验性别作为抑郁症和与活动有关的疼痛之间关系的调节者的作用。
方法：本研究样本由83位参与者（42名女性，41名男性）患有肌肉骨骼疾病组成。要求参与者提起一系列18个不同重量（2.9公斤，3.4公斤和3.9公斤）以及与身体的距离不同的罐。要求参与者在举起每个滤罐时评估他们的疼痛程度，并估算滤罐的重量。
结果：与先前的研究一致，女性抑郁症，疼痛强度和残疾之间的关系比男性强。方差分析显示，抑郁症仅与女性的剧烈活动相关的疼痛有关。对于男性和女性，每次试验都增加了疼痛的强度，尽管举起的物体的重量保持恒定。性别和抑郁都不会影响参与者的体重估计。
结论：本讨论讨论了抑郁症可能通过不同的方式影响男女疼痛的机制。它还解决了女性抑郁症的疼痛增强作用的潜在临床意义。

BACKGROUND & AIMS: :Musculoskeletal conditions (MSC) are common throughout the world and their impact on individuals is diverse and manifold. Knowledge of the determinants for disability and of strategies for prevention and rehabilitation management according to the scientific evidence is critical for reducing the burden of MSC. The first section of this chapter reviews the evidence for common determinants of functioning and disability in patients with MSC. We have focussed on environmental factors (EF) and personal factors (PF) and have structured them according to the International Classification of Functioning, Disability and Health (ICF) framework. The second section discusses prevention strategies. Generally, prevention needs to address those EF and PF that were presented in the first section. The final section describes modern principles of rehabilitation and reviews the evidence for specific rehabilitation interventions.

背景与目标： ：骨骼肌肉疾病（MSC）在世界各地都很普遍，它们对个人的影响是多种多样的。根据科学证据了解残疾的决定因素以及预防和康复管理的策略对于减轻MSC的负担至关重要。本章的第一部分回顾了MSC患者功能和残疾的常见决定因素的证据。我们专注于环境因素（EF）和个人因素（PF），并根据国际功能，残疾与健康分类（ICF）框架进行了结构化。第二部分讨论预防策略。通常，预防需要解决第一部分中介绍的那些EF和PF。最后一部分描述了康复的现代原理，并回顾了具体康复干预措施的证据。

BACKGROUND & AIMS: BACKGROUND:North American indigenous populations experience higher rates of obesity and chronic disease compared with nonindigenous populations. Improvements in musculoskeletal fitness can mitigate negative health outcomes, but is not well understood among indigenous populations. This review examines musculoskeletal fitness measures among North American indigenous populations. METHODS:A total of 1632 citations were evaluated and 18 studies were included. RESULTS:Comparisons of musculoskeletal fitness measures between North American indigenous men and boys and women and girls were generally not reported. The greatest left and right combined maximal grip strength and maximal leg strength among Inuit boys and men and girls and women were observed among 20-29 years age group. Maximal combined right and left grip strength declined from 1970 to 1990, by an average of 15% among adults and 10% among youth. Maximal leg extension among Inuit has declined even further, averaging 38% among adults and 27% among youth from 1970 to 1990. Inuit men demonstrate greater grip strength and lower leg strength than Russian indigenous men, whereas Inuit women demonstrate greater leg strength. CONCLUSIONS:Further research is needed to better understand physical fitness among indigenous peoples and the potential for improving health and reducing chronic disease risk for indigenous peoples through physical fitness.

背景与目标： 背景：与非土著居民相比，北美土著居民的肥胖和慢性病发病率更高。肌肉骨骼适应性的改善可以减轻负面的健康后果，但在土著居民中尚未得到很好的理解。这项审查审查了北美土著人口中的肌肉骨骼适应措施。
方法：总共对1632篇文献进行了评估，包括18项研究。
结果：一般没有报道北美土著男子和男孩与妇女和女孩之间的肌肉骨骼健身措施的比较。在20至29岁年龄段的人群中，因纽特人男女中最大的左右最大握力和最大腿部力量相结合。从1970年到1990年，左右手的最大组合力量下降了，成年人平均下降15％，青年平均下降10％。因纽特人的最大伸腿幅度甚至进一步下降，从1970年到1990年，成年人平均平均伸腿38％，青年平均27％。因纽特人男性比俄罗斯土著男子表现出更大的握力和更低的腿部力量，而因纽特人女性则表现出更大的腿部力量。
结论：需要进行进一步的研究，以更好地了解土著人民的身体适应性，以及通过身体适应性改善土著人民健康和减少慢性病风险的潜力。

BACKGROUND & AIMS: :Brachial plexus birth injury (BPBI) is the most common nerve injury among children. The glenohumeral joint of affected children can undergo severe osseous deformation and altered muscle properties, depending on location of the injury relative to the dorsal root ganglion (preganglionic or postganglionic). Preganglionic injury results in lower muscle mass and shorter optimal muscle length compared to postganglionic injury. We investigated whether these changes to muscle properties over time following BPBI provide a mechanically-driven explanation for observed differences in bone deformity between preganglionic and postganglionic BPBI. We developed a computational framework integrating musculoskeletal modeling to represent muscle changes over time and finite element modeling to simulate bone growth in response to mechanical and biological stimuli. The simulations predicted that the net glenohumeral joint loads in the postganglionic injury case were nearly 10.5% greater than in preganglionic. Predicted bone deformations were more severe in the postganglionic case, with the glenoid more declined (pre: -43.8°, post: -51.0°), flatter with higher radius of curvature (pre: 3.0 mm, post: 3.7 mm), and anteverted (pre: 2.53°, post: 4.93°) than in the preganglionic case. These simulated glenoid deformations were consistent with previous experimental studies. Thus, we concluded that the differences in muscle mass and length between the preganglionic and postganglionic injuries are critical mechanical drivers of the altered glenohumeral joint shape.

背景与目标： ：臂丛神经损伤（BPBI）是儿童中最常见的神经损伤。患儿的盂肱关节可能会发生严重的骨变形和改变的肌肉特性，具体取决于损伤相对于背根神经节（神经节前或神经节后）的位置。与神经节后损伤相比，神经节前损伤导致较低的肌肉质量和较短的最佳肌肉长度。我们调查了BPBI之后这些随时间变化的肌肉特性是否为观察到的节前和节后BPBI之间的骨变形差异提供了机械驱动的解释。我们开发了一个计算框架，该框架集成了代表肌肉随时间变化的肌肉骨骼模型和有限元模型，以模拟对机械和生物刺激的骨骼生长。模拟预测神经节后损伤病例的盂肱关节净载荷比神经节前损伤高近10.5％。神经节后病例中预测的骨变形更为严重，关节盂下降更多（前：-43.8°，后：-51.0°），曲率半径更大（前：3.0mm，后：3.7mm），并且弯曲（前：2.53°，后：4.93°）。这些模拟的关节盂变形与先前的实验研究一致。因此，我们得出结论，神经节前和神经节后损伤之间的肌肉质量和长度差异是改变肱肱关节形状的关键机械驱动因素。