Recent content by cbest

Recommendations - 49th Parallel Coffee - Grouse Grind (nature’s stair master) - Granville Island Brewery - Big walk along the sea wall - Stanley Park - Cafe Medina for brunch - Kitsilano Beach - Nook Italian restaurant - Sea to Sky highway up to Whistler - Tacofino for tacos - Revolver Coffee...

I can’t think of a party I’d wanna be at less

The American delusion of mass shootings with AR-15s being attributed to mental health, not having enough good guys with guns to counteract the bad guys with guns, blah, blah, blah… it’s so asinine. As an outsider having lived in the US for 15 years, I’m somehow continually surprised time and...

Are there any physiatrists in Canada on the forum?

Hi everyone! I’m a Canadian but completed med school, PM&R residency, and pain fellowship in the US. I’m a little over 5 years out from training and am registered to sit for the RCPSC PM&R exam in March. If anyone on here is a recent Canadian PM&R residency grad or knows someone that is, I’d...

Would Duraprep be a decent substitute while the Chloraprep back log sorts itself out?

L5-S1 ILESI or L4-5 infraneural TFESI. There’s zero perineural fat to safely do an L5-S1 TFESI. The L4 nerve root is riding high in the foramen so supraneural TFESI at L4-5 not a great option there. Agree with @lobelsteve there’s no central canal stenosis that’s playing a role here. Highly...

It doesn’t matter. If the X-ray beam is cutting through the lamina, the needle tip will appear at roughly the same depth on a CLO view whether it’s a little bit lateral to the sagittal line or farther lateral. It is the same distance past the lamina so will appear about the same depth on CLO...

With proper use of CLO, it doesn’t matter if you’re a little off of midline or far lateral. The X-ray beam cuts through the lamina the same and the needle tip in relation to that beam is the same. 45 for lumbar, 50 for cervical. Read the Gill articles.

45 for lumbar and lower thoracic. 50 for cervical and upper thoracic. This is straight from Gill et al. Needle must be paramedian for CLO to work properly. If midline, it’ll look deep. If 30-35, it’ll look deeper than it actually is. If 60, it’ll look more shallow than it actually is. Read all...

Needle should not be at midline for two main reasons. First, lack of fusion of ligamentum flavum at midline in C spine. Second, needle will always look deep on CLO if needle at midline. Needle must be paramedian for CLO to be accurate.

Don’t worry about not doing EMGs for your fellowship year. If your job out of fellowship requires you to do EMGs, spend a little time brushing up and start with a few easy CTS cases then build back from there. It’ll come back to you pretty quickly.

Pec tear. Good grief, don’t do a thoracic ESI

Why are you not sending your young folks with FAI to a hip preservation/hip arthroscopy specialist?

Most likely steroid reaction. Typically resolves in 24-48 hours. Sent from my iPhone using SDN mobile