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Biomedical subjects

B M Kummel

Publications and source records attributed to B M Kummel.

12 recordsLinked to original sources
PubMed1996

Nonorganic signs of significance in low back pain.

STUDY DESIGN: Medical records and imaging studies including one or more interviews and physical examinations by the author were reviewed in 878 people remaining out of work for 13 weeks or more because of occupational low back pain. OBJECTIVES: To assess the prognostic value of nonorganic signs, including those validated by Waddell et al and two others previously undescribed, limitation of shoulder motion with production of low back pain, and low back pain resulting from movement limited to the cervical spines. SUMMARY OF BACKGROUND DATA: Review of all records of people evaluated by the author over a 3-year period (1990-1993) provided the material for this study. All available medical, insurance, and legal records were reviewed, including reports or examination results of radiographic films, or both. In the majority, more sophisticated investigation had been performed with complete reports of the studies themselves being available to the author. METHODS: A complete history and physical examination were accomplished by the author on each individual, including evaluation of each of the test results for nonorganicity. Medical records, including radiographic films, magnetic resonance imaging, computerized axial tomography, myelography, bone scan, electromyography, etc., were collated. Statistical analysis of results followed. RESULTS: The finding of limitation of shoulder motion resulting in low back pain indicated a worse prognosis for return to work than that of positive Waddell signs alone, 69.6% versus 52.9%. If cervical motion additionally produced low back pain, the outlook was poorer (no return to work in 73.1%). CONCLUSION: When present with a triad of the signs validated by Waddell, the new signs significantly increase the predictability of failure to return to work by workers with compensable low back pain.

Absenteeism↗
PubMed1980

The diagnosis of patellofemoral derangements.

An accurate differential diagnosis of a patellofemoral injury can be made through careful observation and history-taking and through the use of x-ray examination. For successful treatment, the physician should be aware that internal derangement of the knee is often caused by a combination of lesions.

Adolescent↗
PubMed1980

The treatment of patellofemoral problems.

With few exceptions, patellofemoral problems should initially be treated with conservative measures. If results are unsatisfactory and no contraindications are present, surgery should be considered.

Adolescent↗
PubMedDate not supplied

Spectrum of lesions of the anterior capsular mechanism of the shoulder.

The anterior capsular mechanism appears to be the common denominator in a number of shoulder problems ranging from the recurrent dislocation ("too loose") to the frozen shoulder ("too tight"). The shoulder region and the anterior capsular mechanism can be carefully and accurately assessed by arthrography and cineradiography. Bicipital tenosynovitis has been held accountable for shoulder problems at each extreme of the spectrum. Bicipital tenosynovitis may exist in many shoulders; however, in corrective procedures for the unstable shoulder, the biceps becomes a dynamic reinforcement of the anterior capsule. In the frozen shoulder, the biceps tendon frequently is seen as normal at surgery and the anterior capsular mechanism is identified as the site of the essential lesion. Surgery may switch the patient's problem from one side of the spectrum to the other. Shoulder problems should be investigated thoroughly and evaluated in terms of the patient's requirements for shoulder motion as well as in terms of the orthopaedic surgeon's usual criteria for recommending corrective procedures.

Adolescent↗