Physical medicine and rehabilitation board review

ACKNOWLEDGMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix CONTRIBUTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix INTRODUCTION: BOARD CERTIFICATION . . . . . . . . . . . . . . . . . . xxi 1. STROKE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Richard Zorowitz, M.D., Edgardo Baerga, M.D., and Sara Cuccurullo, M.D. Introduction 1 Basic Neuroanatomic Review of the Major Vessels Involved in Stroke 3 Types of Stroke 6 Diagnostic Studies 17 Treatment 19 Stroke Rehabilitation 25 2. TRAUMATIC BRAIN INJURY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Elie Elovic, M.D., Edgardo Baerga, M.D., and Sara Cuccurullo, M.D. Introduction 47 Mechanism and Recovery of Head Injury 48 Disorders of Consciousness 52 Posturing Secondary to Head Injury 54 Predictors of Outcome After TBI 55 Medical Complications After TBI 63 Mild Traumatic Brain Injury and Postconcussive Syndrome 76 3. RHEUMATOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Thomas R. Nucatola, M.D., Eric D. Freeman, D.O., and David P. Brown, D.O. Rheumatoid Arthritis (RA) 81 Osteoarthritis (OA) 94 Juvenile Rheumatoid Arthritis (JRA) 98 Juvenile Spondyloarthropathies 100 Crystal Induced Synovitis 102 Seronegative Spondyloarthropathies 104 CTD (Connective Tissue Disorders) and Systemic Arthritic Disorders 111 Vasculitis 115 Sjögren’s Syndrome 116 xv CONTENTS  Arthritis and Infectious Disorders 117 Deposition and Storage Disease 119 Other Systemic Diseases 120 Neuropathic Arthropathy (Charcot’s Joint) 121 Fibromyalgia Syndrome (FMS) 124 Complex Regional Pain Disorder (CRPD) 125 Tendon Disorders 127 4. MUSCULOSKELETAL MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Upper Extremities David P. Brown, D.O., Eric D. Freeman, D.O., and Sara Cuccurullo, M.D. Lower Extremities David P. Brown, D.O., Eric D. Freeman, D.O., and Sara Cuccurullo, M.D. Spine Ted L. Freeman, D.O. and Eric D. Freeman, D.O. Upper Extremities—Shoulder Region 131 Shoulder Disorders 138 Upper Extremities—Elbow Region 160 Elbow Disorders 163 Upper Extremities—Wrist Region 174 Wrist Disorders 177 Upper Extremities—Hand Region 182 Hand Disorders 186 Lower Extremities—Hip 191 Hip Disorders 199 Lower Extremities—The Knee 210 Knee Disorders 221 Lower Extremities—The Lower Leg 230 Disorders of the Lower Leg 232 Lower Extremity—Ankle and Foot Region 237 Disorders of the Ankle 240 Foot Disorders 251 Toe Disorders: Hammer, Claw, and Mallet 253 Spine Rehabilitation 256 Disc Disorders 268 Bone Disorders of the Spine 276 Joint Disorders of the Spine 286 Other Infectious Disorders of the Spine 290 5. ELECTRODIAGNOSTIC MEDICINE AND CLINICAL NEUROMUSCULAR PHYSIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . 295 Ted L. Freeman, D.O., Ernest Johnson, M.D., Eric D. Freeman, D.O., and David P. Brown, D.O. Introduction 295 Pathophysiology 311 Nerve Conduction Studies (NCS) 315 Somatosensory Evoked Potentials (SSEP) 326 Basic Needle EMG 328 Upper Limb Mononeuropathy 351 Lower Limb Mononeuropathy 371 xvi  CONTENTS Peripheral Neuropathy 382 Neuromuscular Junction Disorders 390 Myopathy 397 Motor Neuron Disease 404 6. PROSTHETICS AND ORTHOTICS . . . . . . . . . . . . . . . . . . . . . . . . . . 409 Heikki Uustal, M.D. and Edgardo Baerga, M.D. Gait Analysis 409 Prosthetics 416 Assistive Devices—Ambulation Aids 458 Shoes and Lower Limb Orthoses 460 Orthotics 466 Upper Limb Orthotics 473 Spinal Orthoses 481 7. SPINAL CORD INJURIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489 Steven Kirshblum, M.D., Priscila Gonzalez, M.D., Sara Cuccurullo, M.D., and Lisa Luciano, D.O. Epidemiology of Spinal Cord Injury (SCI) 489 Anatomy 490 Spinal Pathology 494 Classification of SCI 500 Medical Complications of SCI 512 Pain in the SCI Patient 545 Pressure Ulcers 547 8. PHYSICAL MODALITIES, THERAPEUTIC EXERCISE, EXTENDED BEDREST, AND AGING EFFECTS . . . . . . . . . . . . . . . 553 Thomas E. Strax, M.D., Priscila Gonzalez, M.D., and Sara Cuccurullo, M.D. Physical Modalities 553 Therapeutic Exercise 570 Effects of Extended Bedrest—Immobilization and Inactivity 576 Evaluation of Functional Independence 578 Physiologic Effects of Aging 580 9. PULMONARY/CARDIAC/CANCER . . . . . . . . . . . . . . . . . . . . . . . . . 585 Pulmonary Priscila Gonzalez, M.D. and Sara Cuccurullo, M.D. Cardiac Iqbal Jafri, M.D. Cancer Lisa Luciano, D.O. and Priscila Gonzalez, M.D. Pulmonary Rehabilitation 585 Cardiac Rehabilitation 610 Cancer Rehabilitation 628 10. PEDIATRIC REHABILITATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645 Roger Rossi, D.O., Michael Alexander, M.D., and Sara Cuccurullo, M.D. Genetics and Chromosomal Abnormalities 645 Development and Growth 647 CONTENTS  xvii Pediatric Limb Deficiencies 653 Diseases of the Bones and Joints 658 Connective Tissue and Joint Disease 669 Pediatric Burns 680 Pediatric Cancers 685 Traumatic Brain Injury (TBI) 688 Cerebral Palsy (CP) 693 Spina Bifida 712 Neuromuscular Disease in Children 721 11. ASSOCIATED TOPICS IN PHYSICAL MEDICINE AND REHABILITATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 743 Spasticity Elie Elovic, M.D. and Edgardo Baerga, M.D. Movement Disorders Elie Elovic, M.D. and Edgardo Baerga, M.D. Wheelchairs Steven Kirshblum, M.D. and Lisa Luciano, D.O. Multiple Sclerosis David S. Rosenblum, M.D. Osteoporosis Barbara Hoffer, D.O. and Sara Cuccurullo, M.D. Burns Alan W. Young, D.O. and Leslie Lazaroff, D.O. Spasticity 743 Movement Disorders 750 Wheelchairs 759 Multiple Sclerosis (MS) 770 Osteoporosis 777 Rehabilitation of Burn Injuries 791 EPILOGUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 803 Thomas E. Strax, M.D.