7 × 10 SPINE: 1.423 black plate An Imprint of Springer Publishing CUCCURULLO PHYSICAL R E HP AH MEDICINE B Y I S L II TC A A AND T L I O M N REHABILITATION E B D O I AC BOARD REVIEW RI N D E R A E N V D I E W Physical Medicine and Rehabilitation Board Review Physical Medicine and Rehabilitation Board Review Fourth Edition Edited by Sara J. Cuccurullo, MD Professor and Chairman Residency Program Director Department of Physical Medicine and Rehabilitation Hackensack Meridian School of Medicine Rutgers Robert Wood Johnson Medical School Physician in Chief HMH Rehabilitation Care Transformation Services, Medical Director and Vice President HMH JFK Johnson Rehabilitation Institute Edison, New Jersey Associate Editor Joseph Lee, MD Clinical Assistant Professor Department of Physical Medicine and Rehabilitation Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Hempstead, New York Assistant Editor Leslie Bagay, MD Clinical Assistant Professor Assistant Director, Residency Program Department of Physical Medicine and Rehabilitation Hackensack Meridian School of Medicine Rutgers Robert Wood Johnson Medical School HMH JFK Johnson Rehabilitation Institute Edison, New Jersey An Imprint of Springer Publishing The editor and publisher wish to acknowledge and thank the artists and photographers that have contributed their work to this and previous editions: photographers Al Garcia and George Higgins, and illustrators Heather L. Platt, Jing Liang, and Sagar Parikh. Visit our website at www.springerpub.com and http://connect.springerpub.com/home ISBN: 978-0-8261-3456-1 ebook ISBN: 978-0-8261-3457-8 DOI: 10.1891/9780826134578 Acquisitions Editor: Beth Barry Compositor: diacriTech Copyright © 2020 Springer Publishing Company, LLC. Demos Medical Publishing is an imprint of Springer Publishing Company, LLC. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Medicine is an ever-changing science. Research and clinical experience are continually expanding our knowledge, in particular our understanding of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of pro- duction of the book. Nevertheless, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the contents of the publication. Every reader should examine carefully the package inserts accom- panying each drug and should carefully check whether the dosage schedules mentioned therein or the contraindi- cations stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Library of Congress Cataloging-in-Publication Data is on file at the Library of Congress. Contact us to receive discount rates on bulk purchases. We can also customize our books to meet your needs. For more information please contact: [email protected] Publisher’s Note: New and used products purchased from third-party sellers are not guaranteed for quality, authenticity, or access to any included digital components. Printed in the United States of America. 19 20 21 22 / 5 4 3 2 1 I dedicate this book to two of the most important people in my life who have passed on: My wonderful father, Pasquale Cuccurullo; his love, support, and encouragement are deeply missed since he passed away from lung cancer in 2004. Also, my dear friend, Kathy Wong, MD. The spirit, integrity, and grace she brought to her patients and the field of Physical Medicine and Rehabilitation is greatly missed since she died of breast cancer at the young age of 36. This book is also dedicated to: My husband Alec, my loving partner in life; My four children Michelle, Alexander, Amanda, and Nicholas, who are the joys of my life; My mother, Connie, my support system throughout my entire life; My mentors and teachers, especially Dr. Thomas E. Strax, my inspiration in all aspects of medicine, both clinical and academic, and Dr. Ernest W. Johnson, my encouragement to take on a challenge; And the residents of the JFK Johnson Rehabilitation Institute Residency Program, whose hunger for knowledge inspired the concept of this review book. It is only because of the support and encouragement of these people that this project could be completed. CONTENTS Foreword xi Preface xiii Acknowledgments xv Contributors xvii Introduction: Board Certification, Kathryn Eckert, DO xxiii 1. STROKE 1 Richard D. Zorowitz, MD, Edgardo Baerga, MD, Sara J. Cuccurullo, MD, Talya Fleming, MD, and Stephanie Chan, MD Introduction 1 Basic Neuroanatomical Review of the Major Vessels Involved in Stroke 4 Types of Stroke 7 Diagnostic Studies 19 Medical Treatment 21 Stroke Rehabilitation 27 2. TRAUMATIC BRAIN INJURY 55 Elie Elovic, MD, Edgardo Baerga, MD, Sara J. Cuccurullo, MD, Christine Greiss, DO, Alphonsa Thomas, DO, Jaime Levine, DO, and Richard J. Malone, DO Introduction 55 Pathophysiology of TBI 57 Disorders of Consciousness 61 Posturing Secondary to Head Injury 63 Prognosis After TBI: An Evidence-Based Approach 63 Medical Management of TBI 70 Surgical Management in TBI 73 Medical and Neurologic Complications After TBI 74 Mild TBI (Concussion) and Postconcussive Syndrome 93 CNS Conditions Secondary to HIV 96 3. RHEUMATOLOGY 101 Thomas R. Nucatola, MD, Eric D. Freeman, DO, Leslie Bagay, MD, Anthony Doss, MD, and David P. Brown, DO Rheumatoid Arthritis 101 Osteoarthritis 113 Juvenile Idiopathic Arthritis (Formerly Juvenile Rheumatoid Arthritis) 116 Juvenile Spondyloarthropathies 118 Crystal-Induced Synovitis 119 Seronegative Spondyloarthropathies 121 Other Rheumatoid Diseases 127 Vasculitides 132 Sjögren’s Syndrome 134 Infectious Arthritides 134 Deposition/Storage Disease-Related Arthritides 136 Other Systemic Diseases With Arthritis 137 Charçot Joint (Neuropathic Arthropathy) 138 vii viii CONTENTS Atraumatic Arthritis 139 Fibromyalgia Syndrome 141 Complex Regional Pain Syndrome 142 Tendon Disorders 144 4. MUSCULOSKELETAL MEDICINE 149 Upper Extremities David P. Brown, DO, Eric D. Freeman, DO, Sara J. Cuccurullo, MD, Sagar Parikh, MD, Laurent Delavaux, MD, and Ian B. Maitin, MD, MBA Lower Extremities David P. Brown, DO, Eric D. Freeman, DO, Sara J. Cuccurullo, MD, Sagar Parikh, MD, Laurent Delavaux, MD, and Ian B. Maitin, MD, MBA Spine Ted L. Freeman, DO, and Eric D. Freeman, DO Upper Extremities: The Shoulder Region 149 Shoulder Disorders 155 Upper Extremities: The Elbow Region 177 Elbow Disorders 180 Upper Extremities: The Wrist Region 190 Wrist Disorders 192 Upper Extremities: The Hand Region 198 Hand Disorders 201 Lower Extremities: The Hip and Pelvis 206 Hip Disorders 214 Lower Extremities: The Knee 226 Knee Disorders 236 Lower Extremities: The Lower Leg 246 Disorders of the Lower Leg 248 Lower Extremity: The Ankle and Foot 252 Disorders of the Ankle 255 Medial Ankle Disorders 258 Foot Disorders 266 Toe Disorders: Hammer Toe, Claw Toe, and Mallet Toe 268 Joint Injections and Aspirations 271 Spine Rehabilitation 275 Disc Disorders 288 Bone Disorders of the Spine 297 Joint Disorders of the Spine 308 Soft Tissue Disorders of the Spine 311 Infections of the Spine 312 Interventional Spinal Procedures 315 5. ELECTRODIAGNOSTIC MEDICINE AND CLINICAL NEUROMUSCULAR PHYSIOLOGY 331 Ted L. Freeman, DO, Ernest W. Johnson, MD, Eric D. Freeman, DO, David P. Brown, DO, and Lei Lin, MD, PhD Introduction 331 Basic Peripheral Nervous System Anatomy 331 Pathophysiology 341 Clinical Instrumentation 346 Nerve Conduction Studies 352 Somatosensory Evoked Potentials 364 Basic Needle EMG 366 Radiculopathy 379 Plexopathies 383 Upper Limb Mononeuropathies 390 Lower Limb Mononeuropathy 407 Peripheral Polyneuropathy 419