Musculoskeletal Diseases Commons^™

Correlation Of Esophageal Dysfunction On High-Resolution Manometry And Chest Ct In Scleroderma, Thao G. Huynh, Zsuzsanna H Mcmahan

Summer Research Program Abstracts

No abstract provided.

Knowledge, Skills, And Attitudinal Gaps In Fibrodysplasia Ossificans Progressiva Diagnosis And Management In The United States, Patrice Lazure, Matthew Drake, Michelle Davis, Corrie Crowe, Zvi Grunwald, Lu Fan, Suzanne Murray

Department of Anesthesiology Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare and disabling disease. Preventing unnecessary and/or harmful medical procedures to patients requires early and accurate diagnosis, multidisciplinary care, and access to specialists with FOP expertise. This study aims to assess the needs of healthcare providers (HCPs) when providing care to patients with FOP. Knowledge, confidence, and management practices were measured through a short awareness survey, completed by 400 HCPs from different specialties who may encounter patients with FOP. Complementary qualitative data were obtained from a dialogue session about FOP. Quantitative data was analyzed using descriptive and inferential analysis, while qualitative data underwent thematic …

A Rare Case Of Invasive Group A Streptococcus Bacteremia, Extensive Streptococcal Myositis, And Septic Knee Arthritis, Cristina Lee, Morgan Seaton, Christina Mie Minami, Bailey Weidner, Dmitriy Scherbak

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Septic Arthritis And Abscess Of The Temporomandibular Joint, Frank Rizzuto, Abdul Khan, Jagan D. Gupta, Neel D. Gupta, Triet M. Do, Enrique Palacios

School of Medicine Faculty Publications

No abstract provided.

Comparison Of Anterior And Posterior Surgical Approaches For Cervical Ossification Of The Posterior Longitudinal Ligament Stratified By Spinal Levels: A Systematic Review And Meta-Analysis, Seyed Danial Alizadeh, Sepehr Khosravi, Farzin Farahbakhsh, Vali Baigi, Moein Khormali, Mohsen Hajiqasemi, Zahra Eskandari, Mahgol Sadat Hassan Zadeh Tabatabaei, Amirmahdi Khayyamfar, Mohammad-Rasoul Jalalifar, Sepehr Armaghan, Masoud Pourghahramani Koltapeh, Zahra Ghodsi, Michael G. Fehlings, Alex R. Vaccaro, Vafa Rahimi-Movaghar

Rothman Institute Papers

OBJECTIVE: To compare the outcomes of anterior and posterior surgical approaches for treating cervical ossification of the posterior longitudinal ligament across multiple spinal levels, including 1-2 spinal levels, ≥ 3 levels, or studies that operated on both spinal levels, called mixed spinal levels.

METHODS: A search strategy using pertinent keywords was employed in the MEDLINE, Embase, Scopus, and Web of Science databases. Data on Modified Japanese Orthopaedic Association (mJOA) scores, radiographic outcomes, and complications were extracted. A random-effects meta-analysis, subgroup meta-analysis, and sensitivity analysis were performed.

RESULTS: Among 13 included studies, the anterior approach was statistically associated with improved C2-C7 …

Medical Guidelines For Fibrodysplasia Ossificans Progressiva, Frederick S. Kaplan, Mona Al Mukaddam, Genevieve Baujat, Alberto Hidalgo Bravo, Matthew Brown, Amanda Cali, Tae-Joon Cho, Corrie Crowe, Carmen L. De Cunto, Patricia L. R. Delai, Robert J. Diecidue, Elisabeth Marelise W Eekhoff, Lisa Friedlander, Clive S. Friedman, Zvi Grunwald, Nobuhiko Haga, Edward C. Hsiao, Richard Keen, Joseph A. Kitterman, Charles Levy, Vrisha Madhuri, Rolf Morhart, J. Coen Netelenbos, Christiaan Scott, Eileen M. Shore, Michael Zasloff, Keqin Zhang, Robert J. Pignolo

Department of Oral and Maxillofacial Surgery Faculty Papers

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic condition characterized by congenital malformations of the great toes and progressive heterotopic ossification (HO) in specific anatomic patterns. Present management summarized here is focused on early diagnosis, assiduous avoidance of injury and iatrogenic harm, symptomatic amelioration of painful flare-ups, and optimization of residual function. Twenty-one members of the International Clinical Council on FOP (ICC) and seven consultants from 15 countries, chosen for their clinical expertise in FOP, developed this summary statement. Further advances in therapeutics will be based on rigorous clinical trials to assess novel and emerging treatment and prevention strategies. A …

Isolated Transaminitis As A Sentinel Sign Of Duchenne Muscular Dystrophy In An Infant: A Case Report, Ayesha Khalid, Tuba Chaudhry, Ayesha Liaqat, Lauren Tufts

School of Medicine Faculty Publications

Duchenne muscular dystrophy (DMD) is an X-linked recessive muscular dystrophy (MD) that typically presents after ambulation due to progressive proximal muscle weakness. The average age of diagnosis is 4.83 years. However, there are some subtle signs that can help in early diagnosis and delay the progression of the disease. We present a non-classical DMD case in a six-month-old infant with failure to thrive, persistent emesis, transaminitis, and truncal weakness, leading to an early diagnosis of DMD. Initial workup for failure to thrive was unremarkable, other than persistently elevated liver enzymes aspartate aminotransferase (AST) and alanine transaminase (ALT) with normal alkaline …

Opposing Synovial Cannabinoid Receptor Type 2 And Transient Receptor Potential Vanilloid 1 Expression In Painful Osteoarthritis, Collin A. Toups, Lauren G. Guillot, Kaitlyn Redondo, Sydney Jensen, Jennifer Klein, Luis Marrero

School of Medicine Faculty Publications

Knee osteoarthritis (kOA) poses a major health challenge worldwide, but current non-surgical treatments have limited long-term success and do not address the underlying disease process. This study explores the complex relationship between the endocannabinoid system (ECS) and the endovanilloid system (EVS) in the synovial membrane of patients with kOA undergoing total knee replacement, focusing on how these systems relate to patient-reported pain and histological synovitis. Synovial tissues and fluid from patients grouped into high and low pain categories based on the Knee Injury and Osteoarthritis Outcome Score (KOOS) were examined for cannabinoid receptor type 2 (CB2R), transient receptor potential vanilloid …

Discontinuation Rates And Predictors Of Medical Cannabis Cessation For Chronic Musculoskeletal Pain, Mohammad Khak, Sina Ramtin, Juliet Chung, Asif M. Ilyas, Ari Greis

Rothman Institute Papers

Medical cannabis (MC) is increasingly used as a treatment for chronic musculoskeletal pain, but there is limited data on factors influencing its discontinuation. This study aims to investigate the rates of MC discontinuation and explore factors influencing it in patients with chronic musculoskeletal pain. A retrospective analysis was conducted on 78 patients certified for medical cannabis over a 2 year period. Patient demographics, pain origin, and Global Physical Health (GPH) and Global Mental Health (GMH) scores were collected before intervention. Discontinuation rates were measured at three-month and one-year follow-up. Statistical analyses, including Fisher's Exact Test and two-sample t-tests, were performed …

Reframing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs): Biological Basis Of Disease And Recommendations For Supporting Patients., Priya Agarwal, Kenneth J Friedman

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a worldwide challenge. There are an estimated 17-24 million patients worldwide, with an estimated 60 percent or more who have not been diagnosed. Without a known cure, no specific curative medication, disability lasting years to being life-long, and disagreement among healthcare providers as to how to most appropriately treat these patients, ME/CFS patients are in need of assistance. Appropriate healthcare provider education would increase the percentage of patients diagnosed and treated; however, in-school healthcare provider education is limited. To address the latter issue, the New Jersey Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Association (NJME/CFSA) has developed …

Case With Refractory Myasthenia Gravis Caused By Pembrolizumab, Khaled M. Darwesh, Bushra Amer, Lateefah D. Hawshab, Fatima D Hawshab

Journal of Community Hospital Internal Medicine Perspectives

Nowadays, checkpoint inhibitors play a major role in the management of different types of cancers. However, we have seen variants of immune therapy-related adverse events, which usually are variables from fatigue, to neuropathy to severe devastating complications such as respiratory failure due to myasthenia gravis (MG), as we saw in our case. Our patient was started on pembrolizumab, and they developed severe respiratory failure attributed to MG after three weeks from treatment initiation. Also, the patient presented with myositis, mild myocarditis and hepatitis, which were all related to pembrolizumab.

Efficacy Of Platelet Rich Plasma On Thumb Basal Joint Osteoarthritis: A Narrative Review, Vrushank Shah, Alexander King

Rowan-Virtua Research Day

Platelet-rich plasma (PRP) has emerged as a potential treatment for carpometacarpal (CMC) joint osteoarthritis, with studies suggesting it may offer more durable symptom relief compared to corticosteroids. A comprehensive review of four studies, including two randomized controlled trials (RCTs), a retrospective study, and a pilot study, revealed that both PRP and corticosteroid injections led to short-term improvements in pain and function. However, PRP demonstrated significantly better long-term outcomes, with VAS scores decreasing from 75 to 20 in the PRP group at 12 months, compared to a modest reduction from 70 to 65 in the corticosteroid group. Additionally, PRP showed a …

The Use Of Intramedullary Screw For Fixation Of Distal Ulnar Fractures, Adam Lencer, John Pignataro, Justin Le, Joyce Daniel Suarez, Michael Rivlin

Rowan-Virtua Research Day

Background

Distal ulna fractures frequently accompany distal radius fractures but are often underappreciated in both clinical and research contexts. While conservative management is frequently employed, particularly following volar locking plate (VLP) fixation of the radius, certain indications, such as distal radioulnar joint (DRUJ) instability, comminution, or high-energy trauma, may necessitate surgical fixation. This study evaluates patient-reported outcomes among patients with distal radius fractures treated operatively, comparing those with and without concomitant distal ulna fractures, and further stratifying based on the method of ulna fixation.

Methods

This retrospective review included 477 patients treated operatively for distal radius fractures by a single …

Does Sports-Specialization Increase The Risk Of Injury In Youth Athletes?, Kinjal Shah

Rowan-Virtua Research Day

Sports specialization, defined as intensive, year-round training in a single sport for more than eight months per year, has become increasingly prevalent among youth athletes. While it is often pursued with the goal of elite performance, early specialization may increase the risk of both physical injuries and psychological strain. This risk is especially pronounced in individual sports such as swimming and tennis, where early and focused training is frequently encouraged. This study explores the association between early sports specialization and injury risk in young athletes, with the goal of identifying contributing factors and informing prevention strategies. Evidence suggests that while …

A Twist Of Fate: A Case Of Spiral Humerus Fracture After Arm Wrestling, Alec Mirchandani, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Fractures of the humerus are relatively uncommon, with spiral fractures typically resulting from rotational forces. This case report describes a 25-year-old male who sustained a right-sided spiral humerus fracture during an arm-wrestling match. The diagnosis was confirmed through radiographic imaging, and the fracture was successfully managed with closed reduction and posterior long arm splinting. This case highlights the importance of recognizing less common mechanisms of injury, like arm wrestling, in the context of humeral fractures. It also emphasizes the effective non-operative treatment of such fractures in young, healthy individuals.

Radiofrequency Ablation Versus Naproxen For The Management Of Ankylosing Spondylitis: A Comparative Analysis, Akash Manish Patel, Alec Birnbaum, Yashas Sattur

Rowan-Virtua Research Day

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation primarily affecting the spinal vertebrae and sacroiliac joints, leading to pain, stiffness, and progressive loss of spinal mobility.

Management typically focuses on alleviating symptoms and controlling inflammation to improve patient quality of life. In this study, we compared the efficacy of two common treatment modalities: radiofrequency ablation (RFA) and naproxen. RFA is a minimally invasive procedure that targets specific nerve endings to interrupt pain signals, whereas naproxen is a non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation and provide symptomatic relief. Our systematic review involved a cohort of AS …

The Gut Microbiome And Knee Osteoarthritis: A Review Of Emerging Pathophysiologic Links, Krisha S. Patel, Maduka Gunasinghe, Umer Shah, Kushkumar K. Patel, Zarif Ladak

Rowan-Virtua Research Day

Background

Knee osteoarthritis (OA), a multifactorial degenerative joint disease with growing prevalence in aging and obese populations, leads to disabling pain. Traditionally viewed as mechanically driven, increasing research implicates systemic inflammation and metabolic and neuroimmune modulation. The gut microbiome—an ecosystem of commensal organisms regulating host immune, metabolic, and inflammatory regulation—has emerged as a potential contributor to OA pathogenesis and symptom severity. This review aims to synthesize literature evaluating associations between gut microbiota composition and knee OA, focusing on inflammatory pathways, pain modulation, and emerging therapies.

Methods

A literature search was conducted using PubMed, Embase, Scopus, and Web of Science. Inclusion …

Efficacy Of Platelet-Rich Plasma In The Management And Treatment Of Achilles Tendon Ruptures: A Literature Review, Justin Le, Savana Coraggio, Emir Shahin, Valentin Nicholas Kotlyar, Joshua Sassaman, Christopher Cherfane, Gilbert Siu

Rowan-Virtua Research Day

Background

In the world of regenerative medicine, platelet-rich plasma (PRP) has gained much attention as a potential enhancer of musculoskeletal healing. However, despite promising results in many applications, the use of PRP in Achilles tendon ruptures (ATR) remains a topic of debate. While some studies suggest potential benefits in terms of pain reduction and early-phase healing, others report no significant difference in clinical or functional outcomes compared to standard treatment. This inconsistency underscores the need for further investigation into PRP’s role in tendon repair, particularly in high-stress, load-bearing structures such as the Achilles tendon.

Objective

This review aims to evaluate …

The Ancient Remedy For Modern Ailments: Analysis Of Manual, Laser, And Electro-Acupuncture Therapy Usage On Carpal Tunnel Syndrome, Yue Chen, Austin J. Wong, Alexander King

Rowan-Virtua Research Day

In the United States, while acupuncture is still primarily used as a complementary therapy, consumer interest and usage are steadily increasing. Carpal tunnel syndrome (CTS), a condition where the median nerve is compressed in the wrist, can lead to numbness, tingling, weakness in fingers, and thus impaired hand function, possessing significant burdens to patients suffering from this chronic disease. Multiple acupuncture applications exist such as electroacupuncture, auricular acupuncture, laser acupuncture, moxibustion, and acupressure; very few comprehensive studies have been done in comparing their effectiveness in treating CTS.

In this study, we aim to conduct a literature review with the primary …

Case Report: Dysphagia In Inclusion Body Myositis Leading To Respiratory And Gastrointestinal Complications, Veroneka Mikhail, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Inclusion body Myositis (IBM) stands as a rare and complex neuromuscular disorder (NMD) characterized by progressive muscle weakness and atrophy. Among its cardinal symptoms are dysphagia and respiratory distress, which are the most common cause of death in this disease. While the differential diagnosis of respiratory distress is vast and includes aspiration, pneumonia, acute coronary syndrome, emphysema, and congestive heart failure, a clinician should recognize that respiratory distress can also be secondary to dysphagia in NMDs like IBM and can quickly become life threating. Here we present the case of a 68-year-old female with a history of IBM who presented …

Leveraging Lower Body Negative Pressure For Enhanced Outcomes In Orthopedic Arthroplasty—Insights From Nasa’S Bone Health Research, Phani Paladugu, Rahul Kumar, Tamer Hage, Swapna Vaja, Tejas Sekhar, Samuel Weisberg, Kyle Sporn, Ethan Waisberg, Joshua Ong, Amar S. Vadhera, Mouayad Masalkhi, Ryung Lee, Chirag Gowda, Ram Jagadeesan, Nasif Zaman, Alireza Tavakkoli

SKMC Student Presentations and Publications

Exposure to microgravity causes rapid bone loss and muscle atrophy, posing serious challenges for long-duration spaceflight. In response, NASA developed countermeasures such as Lower Body Negative Pressure (LBNP) to simulate gravitational loading on astronauts’ lower extremities. LBNP, often combined with exercise, has proven effective in mitigating musculoskeletal degradation during bed rest analogs. This opinion paper argues that LBNP’s success in preserving bone mass and muscle function in microgravity can be translated to improve re- covery after orthopedic arthroplasty on Earth. We draw physiological parallels between microgravity-induced musculoskeletal disuse and the postoperative period following total joint replacement, during which reduced weight-bearing …

Canary In The Carpal Tunnel: A Pilot Study Of The Value Of The Screening For Amyloidosis In Carpal Tunnel Syndrome, Trevor Ruesch, Nevil Khurana, Logan Hansen Md, Katiya Barkho, Julia Malewicz, Charles Day Md

Medical Student Research Symposium

Introduction/Purpose:

Transthyretin amyloidosis occurs in two forms, hereditary transthyretin amyloidosis (hATTR), and wild-type ATTR (wtATTR)². Amyloidosis can result in restrictive cardiomyopathy presenting as heart failure with preserved ejection fraction (HFpEF)⁴. A growing body of evidence demonstrates that amyloidosis may be underdiagnosed and can be caught earlier in the disease course⁵. The proteins causing amyloidosis can also deposit into various tissues including the carpal tunnel leading to carpal tunnel syndrome ².

In this pilot study, we propose that early detection of amyloid via a biopsy of the transverse carpal ligament or tenosynovium in the …

A Case Of Rhabdomyolysis Complicated By Acute Compartment Syndrome After A Ground-Level Fall, Barbara Malaga-Espinoza, Khairiya Haj-Yahya, Corey Haines

Research Symposium

Introduction: Rhabdomyolysis is the breakdown of skeletal muscle tissue that results in the release of intracellular contents such as myoglobin, CK, and electrolytes into the surrounding interstitium and circulation. Rhabdomyolysis is commonly precipitated by trauma, excessive physical exertion, infection, or drug toxicity. Compartment syndrome can be a complication of severe rhabdomyolysis, characterized by increased pressure in a closed anatomical space which can lead to compromised perfusion and ischemia. Timely identification and early surgical intervention are crucial to improving outcomes. Here we present a case of rhabdomyolysis complicated by acute compartment syndrome of the leg in the setting of prolonged poor …

Palovarotene In Fibrodysplasia Ossificans Progressiva: Review And Perspective, Vincent Verheij, Robert Diecidue, Esmée Botman, Joseph Harrington, Nobuhiko Haga, Alberto Hidalgo-Bravo, Patricia Delai, Vrisha Madhuri, Mona Al Mukaddam, Keqin Zhang, Tae-Joon Cho, Rolf Morhart, Richard Keen, Carmen De Cunto, Clive Friedman, Zvi Grunwald, Michael Zasloff, J. Coen Netelenbos, Edward Hsiao, Frederick Kaplan, Robert Pignolo, Christiaan Scott, Elisabeth Marelise Eekhoff

Department of Oral and Maxillofacial Surgery Faculty Papers

INTRODUCTION: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.A., Canada and Australia but remains unapproved in Europe where concerns surrounding the drug and its path to regional market authorization persist.

AREAS COVERED: The developmental history of palovarotene and an overview of the clinical trials and the regulatory approval journey are discussed by global FOP experts.

EXPERT OPINION: While post hoc analyses …

Exploring Microrna Pathways And Metformin's Anti-Inflammatory Potential In Osteoarthritis, Quang D La, Benjamin Tangkamolsuk, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Re: Proteomic Exploration Of Potential Blood Biomarkers In Haemophilic Arthropathy, Quang D La, David F Lo, Don D Shamilov

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We wish to convey our reflections on the scholarly article titled “Proteomic exploration of potential blood biomarkers in haemophilic arthropathy” [1]. This investigation elucidates significant results concerning the plasma proteome of individuals afflicted with hemophilic arthropathy (HA) across a spectrum of severities, accentuating pivotal variations in protein expression correlated with disease severity and emphasizing the intricate nature of HA pathophysiology.

Association Between Mri Findings Of Facet Arthropathy And Synovitis With Health-Related Outcome And Pain Scores Following Therapeutic Lumbar Facet Injections., Michael S Green, Michele Van Hal, Matthew Onimus, Christopher R Hoffman, Dhruv K C Goyal, Valeria Potigailo, Khuram S Kazmi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Low back pain is a common complaint among adults. The facet joint is a major source of lumbar pain, and therapeutic facet injections have gained popularity as a minimally invasive treatment option. In addition, magnetic resonance imaging (MRI) utilization for diagnosing low back pain has increased significantly over the past few decades. Facet synovitis is an entity characterized by edema and inflammatory changes affecting the facet joints, adjacent bone marrow, and surrounding soft tissues. Although its underlying etiology remains poorly understood, recent reports suggest a high incidence in patients with arthropathy and arthritis. It is essential to explore potential correlations …

Prospective Trial Of Sacroiliac Joint Fusion Using 3d-Printed Triangular Titanium Implants: 5-Year Follow-Up, Vikas Patel, S. Craig Meyer, Don Kovalsky, Harry Lockstadt, Jim Farris, Robert Limoni, Abhineet Chowdhary, Philip Yuan, Casey Langel, Andy Kranenburg, Gabriel Tender

School of Medicine Faculty Publications

Study Design. Prospective, multicenter, single arm study with 5-year follow up Objective. To report long-term (5-year) safety, effectiveness, and radiographic outcomes after sacroiliac (SI) joint fusion (SIJF) with 3D-printed triangular titanium implants (TTI) and compare them with solid titanium plasma spray coated implants Summary of Background Data. A large literature base supports minimally invasive SIJF with TTI for chronic SIJ dysfunction. Methods. SIJF with TTI was performed in 51 subjects and scheduled follow-up occurred at 3, 6, 12, 24 and 60 months. Postoperative visits included quality of life questionnaires and functional tests. A high-resolution CT scan was performed at either …

Unveiling The Impact Of Phosphate On Skeletal Muscle Dysfunction In Chronic Kidney Disease, Hiram Garcia, Sowmya Duddu, Erik Hinojosa, Model Zerfu, Nathaniel L. Alvarez, Mohammad Razzaque, Alex Zuo

Research Colloquium

Background: Chronic Kidney Disease (CKD) is characterized by progressive decline in renal function that ultimately culminates in the inability of the kidneys to effectively maintain homeostasis. The kidneys are a key regulator of phosphate, with other organs assisting in regulation including the skeletal system. In CKD, reduced kidney function leads to hyperphosphatemia. While its impact on the skeletal system is moderately studied, its effects on skeletal muscle are less reviewed. In our literature review, we aim to describe the effects of phosphate in the context of patients who have CKD while providing clinical context for this deserving population. We describe …

A Literature Review Of Pain Control In Osteoarthritis Patients Using Blood Flow Restriction Training, John Gericke, Dakota Pastore, Tyler Pigott

Rowan-Virtua Research Day

Background: Osteoarthritis (OA) is a degenerative disease that mainly affects articular cartilage of joints. OA most commonly affects the knees and causes pain and reduces quality of life in older adults. Blood flow restriction (BFR) occludes arterial and venous flow during exercise using a blood pressure cuff placed on the proximal lower limb. This creates an intramuscular hypoxic environment which promotes muscle hypertrophy. High load training can cause pain and inflammation in knee OA patients due to increased stress. BFR can allow patients with knee OA to use lower loads to achieve beneficial effects of rehabilitation.

Methods: Data was ascertained …