CJSM Blog Journal Club — is Low-intensity Pulsed Ultrasound an Effective Treatment in Spondylolysis?

Spondylolysis in the adolescent athlete — what to do?

Symptomatic isthmic spondylolysis in the adolescent athlete — for many of us in the world of primary care sports medicine who have a large pediatric/adolescent patient base, this is one of the more common clinical entities we treat.

I’ve written previously about some of the controversies surrounding this condition, and I have had the pleasure of seeing some of the spondylolysis research I’ve conducted published in the pages of CJSM.

Recently published “On Line first” in CJSM is research coming from a Japanese center renowned for its work in this area:  Low-intensity Pulsed Ultrasound (LIPUS)for Early-stage Lumbar Spondylolysis in Young Athletes.

I’m delighted to introduce again our Junior Associate Editor, Jason Zaremski, M.D., who is pioneering our on-line CJSM journal club.  He’ll take us through this new study and help us decide:  LIPUS — should we be using it in our clinical practice when treating an adolescent-athlete with early-stage, or ‘acute,’ isthmic spondylolysis?

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Clinical Journal of Sports Medicine

Online Journal Club

Jason Zaremski, M.D.

Jason L Zaremski, MD, CAQSM, FACSM, FAAPMR

Title: Tsukada M, Takiuchi T, and Watanabe K. Low-Intensity Pulsed Ultrasound for Early-Stage Lumbar Spondylolysis in Young Athletes. Clin J Sport Med. Published Ahead of Print October 10, 2017. doi: 10.1097/JSM.0000000000000531.

Introduction:

The spring Journal Club commentary for the Clinical Journal of Sports Medicine will be a review of new research examining the effects of pulsed ultrasound for early-stage lumbar spondylolysis in young athletes. This is a retrospective case control therapeutic study with level three evidence. The specific aims of the study were 1) to determine differences in median time to return to previous sports activity with and without the use of low intensity pulses ultrasound (LIPUS); and 2) to determine if healing rates are improved with LIPUS. Read more of this post

‘Think so vs. Know so’: Dr. Jonathan Finnoff on Sports Ultrasound

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Dr. Jonathan Finnoff delivering Grand Rounds in Columbus, Ohio

Earlier this week I was injecting an ankle:  was I in the joint or not?  I ‘think so’–but with an ultrasound I would ‘know so.’ Perhaps that is all I really need to say in this blog post on sports ultrasound!

Readers of the journal and this blog will be familiar with the Mayo Clinic’s Jonathan Finnoff.  Dr. Finnoff has made substantial contributions to the field of sports ultrasound and most recently was the lead author on a highly cited review of this modality.  I had the chance to interview him and profile this work, an American Medical Society for Sports Medicine position statement, in our December 2014 podcast featuring him.

Dr. Finnoff headed a highly regarded sports ultrasound program at the recent 2015 AMSSM conference in Florida.  I arrived a day late for that, and so could not attend.  Not only did I want to go to that program for its educational value, I wanted to meet the man himself!  As I have written, it is both a wondrous and strange attribute of the modern world to become so engaged with someone on Twitter, or Skype, and yet never meet them in person.

I am happy to say my disappointment was short-lived as the busy doctor was able to come visit Columbus, Ohio yesterday.  I was able to catch the sports medicine grand rounds he delivered at Ohio State and get to shake, at last, the hand that holds the transducer.

Jonathan:  it was good to finally meet you!

If you have never had the chance to hear him speak, make sure you avail yourself of the next opportunity [or listen to the podcast :)]  In the mean time, I wanted to share some of what I came away with from the talk. Read more of this post

Ultrasound in Sports Medicine

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Dawn Thompson, MD using the sports med doc’s ‘stethoscope’

The subject of ‘sports’ or ‘musculoskeletal’ (MSK) ultrasound in sports medicine is one of the hot topics in our profession….all around the globe.

It’s been a particular focus here at CJSM since the beginning of the year, when we published two important documents about the subject in the January 2015 issue:  the AMSSM Position Statement on Interventional Musculoskeletal Ultrasound in Sports Medicine and the AMSSM Recommended Sports Ultrasound Curriculum for Sports Medicine Fellowships.

One of the more popular CJSM podcasts we’ve ever produced was the interview I conducted with the lead author of those statements, Jonathan Finnoff, with whom I’m looking forward to catching up at the AMSSM annual meeting taking place this week in Florida.

The issue of ultrasound in sports medicine is not of interest uniquely to Americans, however.  And so I reached out to our newest editorial board member, Junior Associate Editor Dawn Thompson, from the UK, for her perspective from ‘across the pond.’

Dr. Thompson, as well as being a new member of the CJSM Editorial Board, is a member of the  European College of Sports Medicine and Exercise Physicians (ECOSEP) Junior Doctors Committe and a fine writer.  You can expect more guest blog posts coming from here, I’m sure of that.

Thanks Dawn for the post.  And I hope soon to see many of you–reading this post, checking out the position statements, and listening to the podcast–in Florida or elsewhere!

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Dawn Thompson

As a newly qualified doctor interested in pursuing a career in the increasingly popular and competitive field of Sports and Exercise Medicine (SEM) I find myself faced with the same decisions and questions I’m sure many of my peers are also troubling over. For any aspiring SEM doctor what is the best route into the specialty? The options are fairly endless: General Practice, Emergency Medicine, Orthopaedics or even General Medicine seem to be on the cards. Should I complete any post graduate course or qualifications and if so which? And of course the holy grail of any individual lusting over a career in SEM – how do I get practical hands on experience with a sports team or professional athletes?! Read more of this post

Sports Ultrasound and the New Year

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Chillin’ like Bob Dylan: Folly Beach, Charleston, S.C.

Happy New Year y’all!

Returning from lovely Charleston, South Carolina after a relaxing week, I’ll be able to retain a southern, laid-back lilt to my voice for perhaps a day or two more….As many of you would likely agree, there’s nothing quite as bracing as the need to attend to the post-vacation crunch of full email accounts, urgent work-inbox tasks, and full clinic days!

It certainly makes a difference to return to a job and profession one loves.  Sports medicine:  what would I do without you?

I hope you have had a chance to peruse the new, January 2015 CJSM, which is as full of excellent articles as the aforementioned inboxes.  One of the highlights of the issue is the American Medical Society for Sports Medicine Position Statement on Interventional Radiology, which is currently freely available.  I hope, too, you’ve had a chance to catch the new podcast interview with Dr. Jonathan Finnoff, the lead author of the paper.

As a clinician who currently (and regretfully) does not employ sports ultrasound in my current practice, I’m always curious about those professional colleagues who do.  With that in mind, it’s time for the first poll of the year:

Thanks for sharing your thoughts.

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