Bad website advertising on SDN
So while I was on SDN today, I notice a banner ad at the top for setting up NCV in a doctor's office. After clicking on it, it confirmed my suspicions that this is a fly-by-night organization (although...
View ArticleUnilateral H-reflex
A patient complains of LLE numbness, no symptoms on the right. LLE NCS including peoneal and tibial motors and F-waves are normal. LLE sensories are normal. Needle exam is normal. If the left H-reflex...
View ArticleConfusing case - help??
45 y/o guy, healthy, referred by ortho b/c he cant lift his right arm. this has been going on for 5 years. right shoulder MRI is fine, neck MRI is fine. he also has mild parethesias that he complains...
View ArticleNeurophyisologic Classifications?
What are the various neurophysiologic classifications (NCS/Needle EMG) that people use for diagnosising these various conditions? 1) radial neuropathy 2) brachioplexopathy 3) axillary neuropathy 4)...
View ArticleHelp Me with Dennervation potentials..
Hi guys, I saw this pt last week and my attending doesn't seem to think that dennervation was taking place in two of his muscles. I was able to see the persistent regularity of the + sharp waves and...
View ArticleDeep Motor Branch Ulnar Neuropathy
We had an interesting case last week of a lady with a deep motor branch ulnar neuropathy from a pretty severe 5th metacarpal fx. Ulnar CMAP to the ADM was normal (didn't compare her other side though)...
View ArticlePlexus Stretch lesion?
Young gentlemen who fell out of a moving vehicle and hit his shoulder first and then his neck (ie., bringing both apart). Pt noticed tingling for a 24-48 hours after the accident. The weakness in the...
View ArticleLumbosacral L5-S1 plexopathy?
60 y/o male with complaint of unilateral left lower extremity burning pain x 2 years. Starts in his buttocks and the pain goes to his knee. Pt denies any trauma, falls, weakness or atrophy. The pain is...
View ArticleA case for the residents. (THIS IS A REAL CASE)
Chief Complaint: R buttocks pain and "sciatica" 44y/o native American male with history of ESRD (on dialysis) secondary to poorly controlled diabetes and R AKA. Referred by ortho for severe R buttocks...
View ArticleInnervation question
Maybe this is a dumb question... My references always list medial gastroc as S1, S2 innervated. An attending of mine considers it L5, S1, S2 and since I have seen it in some other references. This...
View ArticleRadic vs LTN palsy
49 yo male present to ortho with cc R shoulder pain. In the Hx, neck and R arm pain noted along with R hand tingling. Exam showed benign neck, neuro and shoulder exam except for scapular winging with...
View ArticleElectrical injuries
Saw a very interesting pt today. 21 year old turned on a shop vac at work in April 2010. Apparently someone had plugged the extension cord into a non-grounded 220V outlet (by altering the plug). The...
View ArticleEMG Case help
A guy in his late 50 to early 60's (protecting his ID) with c/o unstable gait for more than 15 years. Pt hasn't had falls. Takins statins but stopped them (not sure for how long was taking). Pt...
View ArticlePronator teres syndrome vs CTS + AIN
39 yo female with 1 year of left arm weakness and numbness, unknown etiology. Not worsening over time. Pain is elbow, forearm and palm, numbness is median nerve and forearm. Strength grossly normal...
View ArticleStatin myopathy and EMG changes
Can statin cause fibrillations/dennervation findings on EMG exam? If that is the case, how long after stopping the statin would the findings not be appreciated anymore? Thx!
View ArticleEMG notes
For what it's worth, I cam across this blog on the web http://emgnotes.blogspot.com/ Seems pretty good. Not sure who started it, but I look forward to reading through it.
View ArticleEMG equipment
What is the best value in EMG equipment? Any vendors to avoid. You may PM me. Thanks
View ArticlePost op nerve injury
Got a call from an anesthesiologist last evening asking me to see someone urgently. Luckily I was still in the hospital. (residents/med students, this is what you build your reputation for, and why you...
View ArticleQotw
I want to get a "Question of the Week" series going, just for fun. I think this could be a good learning opportunity for residents and/or those who are newer to EDx. Attendings can answer, but it'll be...
View ArticleEMG board certification marketing
I just passed the EMG boards and was wondering what others are doing marketing wise? Currently most of my EMGs are generated in house. Do you find that marketing the board certification is useful? Many...
View Articlehelp with NCS/EMG?s
http://forums.studentdoctor.net/showthread.php?p=11037018#post11037018 Sorry if this counts as a double post. Reconsidered that this may be a better place to present this. Thanks
View ArticleWeekly question
Easy one for the week: 45 yo female with numbness in the left hand palmar thumb and index finger. NCS: L Median motor onset 3.8 ms (<4.2) Amplitude 4.1 (>5) NCS forearm 56 (>50) R Median motor...
View Articleweekly question #2
New case from yesterday. I am intentionally witholding information so it is not too easy. Once the right question is asked, I will provide more info. 52 y/o M now 20yrs s/p traumatic L AKA after a...
View ArticleTricky case... need help!
Patient is a 50 year old man with a long term history of DM, as well as a history of hydrocephalus for the past year. He's had recent worsening b/l hand weakness and shoulder pain as well as decreased...
View Articleprox humeral fx with arm/hand weakness
A case for residents: 68 yo female presented with 12 day-old proximal humeral fx. Ortho saw pt 1 week post-injury, ordered CT, and followed-up yesterday. Humeral head has comminuted fx and dislocated....
View ArticleOne call medical
Anyone have any experience working with these guys? Couple large WC groups in my town who wont refer anything unless Im contracted with them. Pretty terrible reimbursement for EDX. Anyone have success...
View ArticleAutologous blood tendon injections
Anybody has any experience doing these in their office for refractory tendinopathies that fail other treatment? I am assuming that this must be easier to do than PRP and with little investment. Any...
View ArticleBoard certification required for EMG payment
Trailblazer Clarification on Updated Policy for EDX Services 6/26/2012 Effective May 1, Trailblazer, the Medicare Administrative Contractor (MAC) for Texas, Colorado, New Mexico, and Oklahoma, began...
View ArticleCPT code for facial nerve study
Does any one know the CPT code for bilateral facial motor nerve recording from nasalis? I know that the blink reflex has V and VII components and the code for that one is 95933-50. Also, bilateral...
View ArticleLarygeal EMG
I was approached by an ENT friend who asked me about laryngeal EMG. He has a woman with bilateral vocal cord paralysis after a thyroid surgery (now with a trach) who he thinks will need it for...
View ArticleWeakness after meningitis
This is a case I'm struggling with. Any thoughts would be greatly appreciated: Patient is a 60ish right-handed homeless male with a history of heavy labor on his hands. He also has a distant history of...
View Articlenot a good way to start the day
my emg patient this morning: "Doc, I am a really good conductor of electricity. I always have been. That is why this test hurts me more than it hurts everyone else" i hope i was able to conceal the...
View ArticleNCS without EMG?
I have been offered to read NCS without EMGs for a certain company. Doing the NCS will provide me with good practice, but I do not want to incur unnecessary risk since it's not a common practice...
View ArticleWhere can i buy cheapest electrodes and EMG needles
With all of the coming reimbursement costs to NCS/EMG, it only makes sense to use cheaper materials. Where can I buy very affordable materials?
View Articleassymetric chest wall
Just saw an interesting young man (kid) in my office. Was seen by his family doc last week for a pre-participation/well child physical, and PCP called me and asked me to see him. 13 y/o boy currently...
View ArticleFacial neuropathy
Female in 40's with complaint of facial paralysis. Patient with surgery done in past to resect vestibular schwanomma. Surgery done on Oct 2012. Presented to clinic for EMG/NCS study. Interpretations 1)...
View ArticleReimbursement
Physician Fee Schedule Final Rule Reveals Results of EMG/NCS Refinement Panel As many of you know, last November, the Centers for Medicare and Medicaid Services (CMS) released its CY2013 Medicare...
View ArticleWorried a co-worker is sick?
I know this is none of my business and I'm an MD resident but not in neurology. I'm worried about a co-worker and I'm not sure if she's properly taking care of herself. She keeps telling me she got...
View ArticleRe: sick coworker thread
Yes, I am well aware that this is not the place to look for consultation. As I said in my original post, it is a curiosity question and the liability still lands on that individual if she states she's...
View ArticleCounting nerves
When doing a median and ulnar antidromic sensory, along with mixed palmar studies to confirm CTS, how many nerve conductions are counted. I have heard different things from different insurance...
View ArticleBilateral EMG Billing
Hey team, I'm wondering how to properly bill for bilateral limb EMG 5+ muscles. Is it two units of 95886 or 95886 with some sort of modifier that I'm not aware of. I'm the only physiatrist at an ortho...
View ArticleStudying for EMG boards
Curious how others are or have studied for this exam. Any particular AANEM study guides that are best? High yield areas? Low yield? Thoughts on the oral part of the exam? Only about a month away......
View ArticleRIC EMG DVD's for ABEM prep
Has anyone used the RIC EDX/EMG DVD's for the AANEM boards? Were they sufficient or useful?
View Article(ABEM) American Board of Electrodiagnostic Medicine
For those who will be taking the exam year this or have taken it in the past, any studying tips, methods, advice? Thanks
View ArticleRelearning EMGs
Hey guys, I am likely taking an interventional spine job that also requires me to do EMGs. I haven’t done one since fellowship and frankly don’t remember much. Anyone been in this situation? Just not...
View ArticleEssential PM&R Articles
Here's the list of essential articles courtesy of Stinky Tofu, compiled by Dr. Francisco at Baylor. Hope this is helpful.
View Articlehyalgan vs synvisc
has anyone come across any studying comparing hyalgan and synvisc? i've done google and pubmed (etc.) searches and haven't found anything. my initial guess is that synvisc is more effective...but then...
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