ABSTRACTIntroduction: Palpation of a thoracic rib is a common method for reducing the risk of pneumothorax during electromyographic examination of the rhomboid major muscle, but its accuracy is unknown. Methods: Two physicians palpated healthy subjects to attempt to identify the center of a rib located beneath the rhomboid major muscle. The identified location was examined with ultrasonography to examine its accuracy and the subject's anatomical depths. Results: Forty‐four subjects (88 ribs) were studied. Palpation demonstrated a 66.3% accuracy rate, with significantly more incorrect palpations seen with greater muscle thickness (P = 0.004) and body mass index (P = 0.037), but not adipose thickness, age, or skin thickness (P > 0.05). Discussion: Palpation of the ribs in an attempt to avoid inadvertent pneumothorax while examining the rhomboid major may be inaccurate, primarily in patients with large muscle bulk. We suggest a brief ultrasound evaluation before electromyography to gauge correct needle depth. Muscle Nerve 57: 61–64, 2018

PM&RVolume 8, Issue 9S p. S199-S199 Musculoskeletal and Sports Medicine Poster 116 Ultrasound Verification of Palpatory Rib Identification for Safe Needle Examination of the Rhomboid Major Muscle Michael D. Campian DO, Michael D. Campian DO University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorDaniel Cushman MD, Daniel Cushman MD University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorMasaru Teramoto PhD, MPH, Masaru Teramoto PhD, MPH University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this author Michael D. Campian DO, Michael D. Campian DO University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorDaniel Cushman MD, Daniel Cushman MD University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this authorMasaru Teramoto PhD, MPH, Masaru Teramoto PhD, MPH University of Utah Medical Center, Salt Lake City, Utah, United StatesSearch for more papers by this author First published: 24 September 2016 https://doi.org/10.1016/j.pmrj.2016.07.159Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume8, Issue9S2016 AAPM&R Annual Assembly AbstractsSeptember 2016Pages S199-S199 RelatedInformation

HISTORY: The patient is a 23 year-old recreational runner who reported acute onset of left foot pain while training for her first marathon. She was on mile 10 of a 16-mile run when she suddenly experienced pain in the region of the medial, plantar aspect of the left mid-foot. There was no specific event that caused the injury, such as stepping on an object or twisting her foot. She was able to finish her run, although the foot pain persisted. The medial mid-foot pain was exacerbated by weight bearing and relieved with non-weight bearing. She provided a history of a leg length discrepancy with the left side long. This had been treated with an insert. She reported no prior foot injuries and no history of stress fractures. There was no numbness, tingling, or weakness, and she reported normal menstrual periods. She had no medical problems and had no surgeries. PHYSICAL EXAMINATION: There was normal foot and ankle alignment. No swelling was present. She was tender to palpation only over the midpoint of the medial longitudinal arch. Active and passive tibiotalar and subtalar motion was normal and did not reproduce any symptoms. There was no pain with motion testing or palpation of the metatarsals, except over the medial longitudinal arch as previously noted. There was normal strength, sensation, and reflexes in the lower limbs. Distal pulses were normal. She did appear to have a leg length discrepancy with the left side 1.5 cm longer. Her gait was antalgic. Pain was reproduced with hopping on the left lower limb. DIFFERENTIAL DIAGNOSIS: 1. Plantar muscle strain 2. Plantar ligament sprain 3. Acute tendon injury 4. Stress fracture TEST AND RESULTS: Left foot AP, lateral, and oblique radiographs: - Normal alignment - No fracture, dislocation, or arthritis Left foot MRI - Partial rupture of the peroneus longus tendon at the distal attachment FINAL WORKING DIAGNOSIS: Partial left peroneus longus tendon rupture at its distal insertion. TREATMENT AND OUTCOMES: 1. Short leg walking boot for four weeks. 2. Physical therapy for a foot and ankle strengthening program. 3. Running gait evaluation. 4. Full, pain-free return to running at eight weeks.

Skiing and snowboarding are sports with an inherent risk of injury. Recently there has been an increasing interest in performing tricks, with the implementation of terrain parks at resorts worldwide. The addition of terrain parks at resorts has likely changed injury patterns and frequencies. PURPOSE: The purpose of this study is to characterize the types of injuries that skiers and snowboarders incur when riding inside versus outside terrain parks, broken down by age group. METHODS: This is a descriptive sports injury epidemiology study in a cohort of patients seen at a large western resort ski clinic. All patients presenting to the clinic during the 2007-2008 and 2008-2009 seasons were included. Injuries were categorized by age, body part and location (i.e. inside versus outside terrain parks). RESULTS: Of the injuries seen in clinic, 22.1% occurred inside terrain parks. The young adult group (17-24 years old) accounted for 47.6% of all terrain park injuries and the child/adolescent (24 years old) groups accounted for 36.5% and 15.9% respectively. In the child/adolescent group the most commonly injured body part inside and outside terrain parks was the wrist (33% and 36.8% respectively). The most commonly injured body part inside and outside terrain parks among the young adult group was the shoulder (25.4% and 22%). In the adult group shoulder injuries occurred more often inside terrain parks (22.2%) while knee injuries were more common outside terrain parks (36.7%). The percent of spine and head injuries inside the terrain parks was double that outside the terrains parks. The most common feature on which injury occurred inside terrain parks was jumps (64.1%). Among those injured on jumps the most commonly injured body part for skiers was shoulder (21.7%) and for snowboarders it was wrist (20.5%). CONCLUSIONS: Injury patterns differ inside versus outside terrain parks with a higher percentage of spine and head injuries inside terrain parks. Injury patterns also differ among age groups. Further research is needed to attempt to make skiing and snowboarding safer.

PM&RVolume 2, Issue 9S p. S52-S52 Scientific Poster Presentation Poster 107: Descriptive Epidemiology of Wrist and Hand Injuries Among Skiers and Snowboarders Pontus Oberg DO, Pontus Oberg DO University of Utah, Salt Lake City, UTSearch for more papers by this authorQing Chen DO, Qing Chen DO University of Utah, Salt Lake City, UTSearch for more papers by this authorChristopher Gee MD, Christopher Gee MD University of Utah, Salt Lake City, UTSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah, Salt Lake City, UTSearch for more papers by this authorUlrike Ott MSPH, Ulrike Ott MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorMichelle Pepper MD, Michelle Pepper MD University of Utah, Salt Lake City, UTSearch for more papers by this authorMatthew S. Thiese PhD, MSPH, Matthew S. Thiese PhD, MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorStuart E. Willick MD, Stuart E. Willick MD University of Utah, Salt Lake City, UTSearch for more papers by this author Pontus Oberg DO, Pontus Oberg DO University of Utah, Salt Lake City, UTSearch for more papers by this authorQing Chen DO, Qing Chen DO University of Utah, Salt Lake City, UTSearch for more papers by this authorChristopher Gee MD, Christopher Gee MD University of Utah, Salt Lake City, UTSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah, Salt Lake City, UTSearch for more papers by this authorUlrike Ott MSPH, Ulrike Ott MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorMichelle Pepper MD, Michelle Pepper MD University of Utah, Salt Lake City, UTSearch for more papers by this authorMatthew S. Thiese PhD, MSPH, Matthew S. Thiese PhD, MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorStuart E. Willick MD, Stuart E. Willick MD University of Utah, Salt Lake City, UTSearch for more papers by this author First published: 25 September 2010 https://doi.org/10.1016/j.pmrj.2010.07.138Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume2, Issue9SSeptember 2010Pages S52-S52 RelatedInformation

PM&RVolume 1, Issue 9S p. S158-S158 Poster Presentation Poster 125: Descriptive Epidemiology of Ski and Snowboard Injuries by Age Group: Children/Adolescent, Young Adult, Adult Michael Henrie DO, Michael Henrie DO University of Utah, Salt Lake City, UTSearch for more papers by this authorStephen K. Aoki MD, Stephen K. Aoki MD University of Utah, Salt Lake City, UTSearch for more papers by this authorJeremy Biggs MD MSPH, Jeremy Biggs MD MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorStuart E. Willick MD, Stuart E. Willick MD University of Utah, Salt Lake City, UTSearch for more papers by this author Michael Henrie DO, Michael Henrie DO University of Utah, Salt Lake City, UTSearch for more papers by this authorStephen K. Aoki MD, Stephen K. Aoki MD University of Utah, Salt Lake City, UTSearch for more papers by this authorJeremy Biggs MD MSPH, Jeremy Biggs MD MSPH University of Utah, Salt Lake City, UTSearch for more papers by this authorStuart E. Willick MD, Stuart E. Willick MD University of Utah, Salt Lake City, UTSearch for more papers by this author First published: 25 September 2009 https://doi.org/10.1016/j.pmrj.2009.08.145Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume1, Issue9SSeptember 2009Pages S158-S158 RelatedInformation

PM&RVolume 1, Issue 9S p. S280-S281 Poster Presentation Poster 405: Safety of Aquatic Treadmill Therapy in Ambulatory Adult Stroke Patients: A Case Report Steven R. Edgley MD, Steven R. Edgley MD University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorHeather Hayes DPT, Heather Hayes DPT University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorDutch M. Plante BSN, Dutch M. Plante BSN University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this author Steven R. Edgley MD, Steven R. Edgley MD University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorHeather Hayes DPT, Heather Hayes DPT University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorMichael Henrie DO, Michael Henrie DO University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this authorDutch M. Plante BSN, Dutch M. Plante BSN University of Utah School of Medicine, Salt Lake City, UTSearch for more papers by this author First published: 25 September 2009 https://doi.org/10.1016/j.pmrj.2009.08.433Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume1, Issue9SSeptember 2009Pages S280-S281 RelatedInformation