According to an article in the April 2005 issue of Archives of Internal Medicine, undetected osteoporosis in the elderly might be discovered if chest radiographs, done for other reasons, are examined for fractures of the vertebrae.

"The most noteworthy finding in our study is the magnitude of the underdiagnosis and undertreatment of osteoporosis in elderly patients with a vertebral fracture," said Sumit R. Majumdar, MD, MPH, and his colleagues from the University of Alberta Hospital, Edmonton, Canada. "One in six elderly patients who underwent chest radiography in our emergency department had clinically important vertebral fractures. Nevertheless, only 43 (60%) of these fractures were reported, and only 25% of patients with fractures received a diagnosis of or treatment for osteoporosis."

Majumdar and his colleagues selected a random sample of about 10% of patients older than 60 years of age who had been evaluated in the emergency department of a large teaching hospital and had a chest radiograph done for any reason. The charts and radiographs were then reviewed in detail to determine whether the patient had a moderate to severe vertebral fracture.

Of the 459 patients studied, 72 (16%) had a moderate to severe vertebral fracture on the basis of their radiograph. Forty-three (60%) of the fractures were documented in the original radiograph reports. Of the 72 patients with fractures, only 18 (25%) had a history of osteoporosis.

According to the article, previous studies estimate that 12% to 25% of people 50 to 60 years of age have one or more osteoporosis­-related vertebral fractures. While only 30% of these fractures come to medical attention, the remaining 70% are associated with illness, death, decreased quality of life, and increased risk of future fractures.

Gov. Christine Gregoire (D-Wash) signed legislation into law recently that ensures that PTs in the state of Washington are practicing under the most up-to-date and highest standards.

"The passage of the legislation clarifies, for consumers and health care professionals, that physical therapy services must be provided by, or be under the direction of, a licensed physical therapist," said Richard L. Bettesworth, PT, president of the Physical Therapy Association of Washington.

The updated definition of physical therapy, as noted in the legislation, reflects the actual treatment techniques by PTs on a daily basis, including manual therapy, joint mobilization, wound care, and needle electromyography.

On the football field or in the hockey rink, competitors often resume play and assume risk, after answering a few questions from the coach, following a mild concussion. However, thanks to a couple of biomedical engineers, a new device quickly detects mild traumatic brain injury in the heat of sports competition.

Michelle La Placa, assistant professor of biomedical engineering at the Georgia Institute of Technology, and David Wright, assistant director of Emory University’s emergency Medicine Research Center, developed DETECT, a portable device that assesses problems associated with concussions in about 7 minutes. DETECT includes software, a portable computer, a video-game-type controller, earphones, and headgear with a video display. The device is automated and can be operated by a coach or parent.

"DETECT is novel because it allows sideline assessment in the minutes following a suspected concussion and can be used to assist the team physician or trainer in return-to-play decisions," said LaPlaca.

LaPlaca and Wright are currently testing DETECT in several research settings and hope to see it available for widespread use in the next few years. They hope that, with special software, it could be used for cognitive testing related to other mental conditions or diseases, such as Alzheimer’s.

A survey of 1,111 working women, conducted at Temple University School of Medicine, Philadelphia, found that while most women suffer from pelvic floor disorders (PFD), the majority don’t seek help until they are incontinent. While 72% of the women surveyed reported suffering from one or more pelvic floor disorders, 70% had not sought medical help.

"They cannot tolerate leaking urine and the disruption to their daily lives," said Jack Mydlo, MD, professor and chair of urology at Temple University. "But incontinence is usually just the tip of the iceberg. Many are also suffering from such pelvic floor disorders as uterine or rectal prolapse."

Among the study participants, significant risks for PFD were older age, high body mass index, the number of vaginal births, and the use of forceps.

The researchers recommend that pelvic floor disorders be a part of routine physical examinations for all women.