This descriptive retrospective cohort study utilized a large workers comp insurer database. All MRI's performed on peripheral joints during calendar year 2017 that were (a) 2 weeks after the initial clinic visit, or (b) greater than 6 weeks after injury, but (c) not more than 3 months after the date of injury were evaluated in this study. Individual diagnoses rendered on MRI reports for these cases were categorized as to whether ultrasound alone or ultrasound + xray could adequately provide the same diagnoses. Results showed that, ultrasound + xray would be able to provide all of the same diagnoses compared to MRI in 54% of cases vs 33% of cases using ultrasound alone, highlighting the utility of using ultrasound and xray together. The proportion of cases where ultrasound + xray could reasonably be substituted for MRI increases to 70% overall when less severe diagnoses, considered not likely to change management, were excluded from analysis. If point of care ultrasound was performed for all 1482 cases with subsequent MRIs pursued in only 30% of cases, a cost savings between $456,186 and $331,698 would be realized, translating to $308 to $224 per patient. Additionally, if ultrasound + xray was performed at the point of care during the first clinic visit for an injury, the definitive diagnoses could be reached on average 33.3 days earlier. In total, these results suggest a significant proportion of musculoskeletal workers comp injuries could be accurately and completely evaluated at the point of care using ultrasound and xray together. This could yield greater provider and patient confidence in the diagnosis and treatment plan as well as more expeditious accurate diagnoses leading to reductions in both direct and indirect costs.

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The diploma thesis evaluates the morphology of the abdominal wall muscles focusing on the assessment of lateral symmetry in elite female floorball players and its relationship with the occurrence of back pain in these players. The theoretical part of the thesis includes an overview of the physiological mechanisms of postural stabilization in comparison with deviations in patients with back pain and describes the principles of sonographic examination and its use in physiotherapy. The theoretical part is also focused on the imagining of the abdominal muscles and the summary of specific findings in floorball players and other athletes, with a predominant one-sided load related to the biomechanics of movement in these sports. Methodology: A total of 20 female players of the highest floorball competition in the Czech Republic participated in this research. The linear parameters of the abdominal muscles (m. RA, m. TrA, m. OI and m. OE) and the whole lateral abdominal muscles were measured in players on both sides at rest using sonography. The participants also filled in an electronic questionnaire evaluating back pain. Results: Significant lateral asymmetry of linear parameters of abdominal muscles was demonstrated in the work (p = 0,017; d = 0,52). The relationship between the lateral asymmetry and the...

1 Abstract The aim is to investigate whether the distal femoral cartilage (DFC), Achilles tendon (AT) and plantar fascia (PF) were different between healthy young women wearing high-heel shoes (HHS) (> 5 cm) and flat shoes (< 1.4 cm). Measurements from aforementioned structures were obtained by using ultrasound. There were 910 measurement parameters analyzed in total. There were 34 women in the HHS group (mean age 31.1±6.4 years; BMI 21.6 ± 2.3 kg/m2 ) and 57 women in the control group (mean age; 29.5 ± 7.3 years; BMI 22.5 ± 3.4 kg/m2 ). Wearing HHS resulted in thickening of the right medial DFC (2.00 ± 0.41 mm) and left AT (4.07 ± 0.48 mm) in women wearing HHS compared to flat shoes (1.96 ± 0.35 mm, 3.76 ± 0.66 mm, respectively). This might be interpreted as secondary to chronic overload. PF thicknesses were similar both within and between group. Our findings have shown significant thickening of the right medial DFC and left AT in women wearing HHS and these changes might be interpreted as secondary to chronic overload. Further follow-up studies are definitely awaited to provide a better insight into understanding the musculoskeletal consequences of this "social" issue ever-existing in ladies lives. The secondary aim of the thesis comprises two case reports: 1. the first is describing the usefulness of MSK...