Jols99

@DrJN_SportsMed Thank you for this nice case. I was just wondering if you could see evidence of this with any other imaging modality. In particular would an MRI be able to see the abnormal rib positions.

Consent✅ Female, 20s L upper abdominal pain since lockdown - on back of increased home work outs including ab & core work Now pain lying supine, prone, trunk rotation, being hugged, deep inspiration.... Hugely impactful on QoL Seen multiple specialists - GI, gynae (!), respiratory - utterly frustrated Referred as possible ACNE syndrome - but not in the right place anatomically (ACNE is peri-umbilical semilunaris border) OE - hypermobile ? EDS Focal pain on gentle palpation into immediate L inferior costal margin EROM thoracic rotation painful, plus trunk flexion / extension POCUS video - L 'floating rib' - possibly 11th - seen subluxed superficially over adjacent rib, vs normal side sat 'flush' On deep inspiration, pain reproduced with probe pressure maintained as irritable over-lying soft tissue 'tents' Diagnosis - 'Floating rib' or 'rib tip' syndrome Outcome - symptoms validated - no more medical 'rabbit holes' - surgical resection

@uncrownedcombat @arielhelwani @lewiswatson_8 Well written piece.

The life of a journeyman 🥊 In 101 pro fights across seven years, England's Jake Pollard has lost 100 of them. Yet he not only survives, but thrives in a sport that quietly depends on men just like him. ✍️ @lewiswatson_8 sports.yahoo.com/boxing/article…

@zach_freimark Spoke to soon

There is no way they keep this call. #Gophers

@DrJN_SportsMed I have noticed this on many of my patients as well. Usually need to rule out the back with an MRI before I conclude that it is the piriformis.

Expanding on this & personal reflection.... These are my MRI STIR images (sagittal) - shows bilateral L5 nerve root oedema secondary to stenosis / compression I have deep seated superolateral gluteal pain & tenderness ++ on palpation into 'piriformis' both sides - including sitting & rolling onto that zone I have no doubt this is pain reproduced by palpating the sciatic nerve as it passes on its route through the deep gluteal space (including deep or through piriformis) - NOT muscular pain But I can understand why patients & clinicians mis-diagnose this & attack the piriformis for treatment - release work, stretching, hockey ball, theragun..... & unsurprisingly it makes things worse - its just p&*sing off an already irritable nerve tract I can also reproduce my gluteal pain by palpating the CPN at the fibular head & by tapping the medial plantar nerve!! I see this in plenty of other neural cases - palpating / Tinel's test a nerve 'downstream' from the principle compression zone ellicits pain proximally

@ATRightMovies @grok how much money did this movie make

What the most underrated sci-fi movie?

Let’s be real. I spoke out against a big insurance company and now I’m being punished for it. But I’m not giving up. It’s not in my blood. I heard you asking, and if you would like to help, I’ve started a gofundme (linked below) where you can read the details and consider contributing. Just showing up and following means the world to me. I’ll keep it transparent so we can all see what medicine in the US is like in 2025 and hopefully build something better for all of us. gofundme.com/f/stand-with-a…

@Mike_kim714 154

First person to guess my locker number this week at Oakmont gets it It’s between 1-200

Not sure if some would be into this but would someone want my tour bag? The one I’ve used since Bay Hill (Clubs not included haha)

@DireStraits77 2nd best solo in this song at this performance.

Dire Straits - Sultans Of Swing ( I can’t find enough words to describe this solo, Just Amazing ❤️)

@samvance Your body will get used to it over time and you won’t be so tired. I went through a similar thing, though I did not lose as much weight as you.

I’m just constantly tired now, consequences of a year long caloric deficit. I’m eating 2,000 - 2,500 calories per day, but someone my size would need to eat at least 4,000 calories per day to sustain my current weight… So, yeah… I’m exhausted always

This time a year ago, I was staying my first night in the hospital, having just been admitted late that night. In the year since, my glucose went from 296 in the ER to 60’s-80’s now. My A1C went from 9 to 5. I haven’t weighed in since early March, but I’m down at least 115lbs.

@samvance Great job!!!

Some doctors with a history of being sued for malpractice find new careers working for insurance companies, where they make decisions on thousands of patients' treatment requests. propublica.org/article/malpra…

A flyover of Metropolitan Stadium & surrounding area in 1984.

@AshleyGWinter I’m sorry you have been so ill. I hope you are feeling better soon.

I'll post a long thread about it but I just wanted everyone to know I'm alive and out of the hospital. This has been an absolutely horrible month and I've been close to death. Hug your people- nothing else matters in the end.

I just want to tweet out this C. S. Lewis quote every weekend

@Xris32 @AdamCSharp @richardosman Air wolf

For the podcast this week, what's the best TV theme tune? Feel free to say why as well if you wish!

Andy Rooney landed on the beach of Normandy days after D-Day, 80 years ago today. In 2004, he shared a firsthand account of “a day unlike any other.” “It’s hard for anyone who has been in a war to describe the terror of it to anyone who hasn’t,” he said. cbsn.ws/3yTkNzC.

@sportsphysiouk @beinglewis @TDekkersPhysio I think their his

@beinglewis @TDekkersPhysio hi mate worth removing pt identifier on the images u shared pt id is visible

Would you recommend this patient to run? 🏃‍♂️ Saw this 72 year old yesterday who wants to run 5km per day. Pt is an ex 2:20 marathon runner and had been doing 5-10km regularly >12 months ago.   Hx Previous severe back pain R leg pain- min pain in last year. Numbness R sole of foot Able to walk 5Km without pain   MRI Severe disc degeneration at L3/4 and L4/5 L5/S1 Spondylolisthesis All levels L4-S1 showing  significant central canal stenosis   Exam Reduced lx extension (stiff not pain) Has absent R patellar reflex Reduced sensation R sole SLR -85 bilateral How would you manage this patient?

@BSwanson1107 @BillyTMtn @MNTwinsZealot And Richard Coffey

@BillyTMtn @MNTwinsZealot Eric Harris, Bobby Jackson, Sam Jacobson, Courtney James, John Thomas. Quincy Lewis off the bench too.

March Madness in 1997 was sweet. I was a senior at the U and the Gophers were a #1 seed and on their way to the Final Four. Those were the days…

🤣🤣

I’m not a Pogues fan, but as a fan of humanity, I’m telling you this is almost certainly the greatest thing you’ll see on this app today. From the funeral of Shane MacGowan over in Ireland. twitter.com/gavreilly/stat…