Spontaneous spinal epidural hematoma is an uncommon cause of spinal cord compression. It may be associated with various causative factors, but in many patients, anticoagulation can be implicated. It is noteworthy that many of the reported cases were anticoagulated in the therapeutic range. Spontaneous spinal epidural hematoma should be suspected in any patient receiving anticoagulant agents who complains of local or referred spinal pain associated with limb weakness, sensory deficits, or urinary retention. Early diagnosis and treatment are very important for the functional recovery of the patient. Spinal magnetic resonance imaging is the most suitable neuroradiological method for early diagnosis. Although primary management is the surgical evacuation of the spinal epidural hematoma via laminectomy, rare cases in which the patient is improving rapidly and progressively could be treated conservatively. A 22-yr-old man with a spontaneous spinal epidural hematoma who was receiving warfarin treatment for a mechanical aortic valve is presented in this article.

No abstract

This study demonstrated the superiority of the IFC with some advantages on pain and disability outcomes when compared with sham IFC for the management of knee osteoarthritis. However, the effectiveness of different amplitude-modulated frequencies of IFC was not superior when compared with each other.

Background Lateral epicondylitis (LE) is one of the most common conditions affecting elbow [1]. Primary aims of treatment are pain relief and restoration of muscle condition [2]. There is a wide spectrum of treatments used in daily practice for management of LE such as analgesic medications, physical therapy, exercise and orthoses. Despite the large number of trials undertaken on LE, no treatment has been proven to be universally effective or generating consensus on its management [3]. Objectives The aim of this study was to determine and compare the efficacy of TENS and kinesiotaping (KT) treatments in LE. Methods In this prospective-randomised, assessor blinded controlled trial; 78 patients (63 women, 15 men, mean age 47,5±7,94 years) with LE were enrolled. Patients were allocated into 4 treatment groups, for a duration of 10 days. Group 1 received TENS +KT, group 2 received TENS+sham KT, group 3 received sham TENS+KT and group 4 received shamTENS+sham KT. All patients were given a progressive exercise regimen and were informed about the disease. Outcome measures were pain-free grip strength, pressure pain threshold and pain severity at rest, night and forced wrist extension test. Patient rated tennis elbow evaluation (PRTEE) was used to determine the functional status. Patients were assessed for the outcome measures at the 10th day and 12 th week of the follow up period. Results At day 10, TENS, KT and TENS+KT combination treatments were statistically superior to sham group in primary outcome measures (P<0.05). At week 12, all groups including sham treatments had statistically significant improvements compared to pre-treatment, however there were no significant differences among groups. Conclusions To our knowledge, this is the first study evaluating TENS and KT in LE. In this study we found that TENS, KT and TENS+ KT combination therapies have positive effects on pain, function and quality of life in acute management of LE. However these positive changes in acute period could not be sustained at week 12. This may be attributed to the self-limiting nature of the disease over time [4–6] or to the positive effects of advice about activities and exercise programme at the sham group. Further research is needed to confirm these results. References Randall L. Braddom. Physical Medicine and Rehabilitation. Elsevier Health Sciences, 2010;835-836 Vincenzino B. Lateral epicondylalgia: a musculoskeletal physiotherapy perspective. Man Ther 2003;8:68–79. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005;39(7):411-22. Cyriax JH. The pathology and treatment of tennis elbow. J Bone Joint Surg 1936;18:921-38. Hudak PL, Cole D, Haines T. Understanding prognosis to improve rehabilitation: the example of lateral elbow pain. Arch Phys Med Rehabil 1996;77:586-93. Murtagh JE. Tennis elbow. Aust Fam Physician 1988;17:90,91,94-5. Disclosure of Interest : None declared DOI 10.1136/...

No abstract