UTHSC PA Program Podcast

In this episode, we review nursemaid's elbow, also known as radial head subluxation, a common upper extremity injury in young children. We discuss the typical mechanism—sudden traction on an extended arm, such as when a child is lifted or swung by the hand—which causes displacement of the annular ligament around the radial head. The episode highlights classic clinical findings including a child holding the arm slightly flexed and pronated while avoiding movement due to pain. We also review the primarily clinical diagnosis, when imaging may be necessary, and the simple but effective treatment of closed reduction, after which most children regain normal arm use within minutes. Key clinical pearls include the high recurrence rate and the importance of prevention, particularly avoiding pulling or lifting young children by the arms.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Nardi NM, Schaefer TJ. Nursemaid Elbow. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430777/
3. Shaath K, Shirley E. Nursemaid's elbow. Orthobullets. Updated August 21, 2022. Accessed March 9, 2026. https://www.orthobullets.com/pediatrics/4012/nursemaids-elbow

In this episode, we review osteoporosis, a common metabolic bone disease characterized by decreased bone density and increased fracture risk due to an imbalance between bone resorption by osteoclasts and bone formation by osteoblasts. We discuss key risk factors such as aging, postmenopausal estrogen loss, low BMI, smoking, and sedentary lifestyle, along with the epidemiology showing that 1 in 2 women and 1 in 5 men over age 50 will experience an osteoporosis-related fracture. The episode highlights the often silent progression of the disease until fractures occur, as well as classic clinical findings such as height loss, kyphosis, and fragility fractures. We also review diagnostic tools including DEXA scans, T-scores, and FRAX fracture risk assessment, and discuss treatment options such as bisphosphonates, denosumab, and anabolic therapies like teriparatide. Finally, we cover prevention strategies including weight-bearing exercise, adequate calcium and vitamin D intake, and routine screening to reduce fracture risk and maintain bone health.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Ye C, Ebeling P, Kline G. Osteoporosis The Lancet. 2025; 406(10514):2003-2016.
3. Morin SN, Leslie WD, Schousboe JT. Osteoporosis: A Review. JAMA. 2025 Sep 9;334(10):894-907. doi: 10.1001/jama.2025.6003. PMID: 40587168

In this episode, we review compartment syndrome, a limb-threatening orthopedic emergency caused by increased pressure within a closed muscle compartment that compromises tissue perfusion. We discuss the underlying pathophysiology of rising intracompartmental pressure leading to ischemia, cellular hypoxia, and potential muscle and nerve damage. The episode highlights common causes such as fractures, crush injuries, burns, vascular trauma, and reperfusion injuries, along with nontraumatic triggers like intense physical exertion or prolonged immobilization. Key clinical features—including severe pain out of proportion to exam, pain with passive stretch, paresthesias, and tense compartments—are emphasized to aid early recognition. We also review diagnostic considerations, the role of compartment pressure measurement, and the urgent treatment of emergent fasciotomy to prevent devastating complications such as permanent nerve damage, rhabdomyolysis, amputation, or death.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Torlincasi AM, Lopez RA, Waseem M. Acute Compartment Syndrome. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448124/
3. Novak M, Penhaker M, Raska P, Pleva L, Schmidt M. Extremity compartment syndrome: A review with a focus on non-invasive methods of diagnosis Front. Bioeng. Biotechnol.. 2022; 10.

In this episode, we review spinal trauma, focusing on rapid recognition, evaluation, and early management of potential spinal instability and neurologic injury. We discuss common mechanisms such as motor vehicle collisions, falls, and diving injuries, and emphasize the importance of spinal motion restriction when trauma patients present with risk factors like midline tenderness, neurologic deficits, altered mental status, or distracting injuries. The episode also covers key clinical decision tools including the NEXUS criteria and Canadian C-spine rule, along with appropriate imaging strategies—highlighting CT as the preferred modality for fractures and MRI for ligamentous or spinal cord injuries. We review vertebral fracture classifications, the TLICS scoring system, and critical complications such as spinal cord injury and neurogenic shock. Finally, we outline essential management principles, including maintaining adequate spinal cord perfusion and preventing hypotension, to help reduce secondary neurologic injury.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic Spinal Cord Injury: An Overview of Pathophysiology, Models and Acute Injury Mechanisms Front. Neurol.. 2019; 10.
3. Mensah EO, Chalif JI, Johnston BR, et al. Traumatic spinal cord injury: a review of the current state of art and future directions – what do we know and where are we going? North American Spine Society Journal (NASSJ). 2025; 22:100601-.
4. van Den Hauwe L, Sundgren PC, Flanders AE. Spinal Trauma and Spinal Cord Injury (SCI) 2020 Feb 15. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554330/ doi: 10.1007/978-3-030-38490-6_19

In this episode, we review systemic lupus erythematosus (SLE), a chronic multisystem autoimmune disease driven by immune complex deposition and widespread inflammation. We discuss the epidemiology—most commonly affecting women of childbearing age—and the classic clinical presentation including fatigue, photosensitive rash, symmetric inflammatory arthritis, and constitutional symptoms. The episode highlights hallmark findings such as the malar ("butterfly") rash, cytopenias, and potential renal involvement leading to lupus nephritis. We also review key diagnostic laboratory markers including ANA, anti–double-stranded DNA, and anti-Smith antibodies, as well as important complications like avascular necrosis related to corticosteroid therapy. Finally, we outline treatment strategies centered on hydroxychloroquine, with escalation to corticosteroids or immunosuppressive therapy for more severe disease, and discuss clinical features that help differentiate SLE from rheumatoid arthritis.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Siegel CH, Sammaritano LR. Systemic Lupus Erythematosus JAMA. 2024; 331(17):1480-.
3. Justiz Vaillant AA, Goyal A, Varacallo MA. Systemic Lupus Erythematosus. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535405/
4. Hoi A, Igel T, Mok CC, Arnaud L. Systemic lupus erythematosus The Lancet. 2024; 403(10441):2326-2338.

In this episode, we review key genetic connective tissue disorders that commonly appear in clinical practice and board-style exams: Ehlers-Danlos syndrome, Marfan syndrome, and osteogenesis imperfecta. We discuss how defects in connective tissue proteins lead to systemic structural weakness affecting the joints, bones, skin, and cardiovascular system. The episode highlights distinguishing clinical features such as joint hypermobility and skin fragility in Ehlers-Danlos syndrome, tall stature with aortic root dilation in Marfan syndrome, and recurrent fractures with blue sclera in osteogenesis imperfecta. We also review major complications, including vascular rupture in EDS, life-threatening aortic disease in Marfan syndrome, and severe bone fragility in OI, along with key management strategies and diagnostic clues to help differentiate these disorders in both clinical practice and exam scenarios.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Marwa K, Anjum F. Undifferentiated Connective Tissue Disease. [Updated 2023 Apr 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572061/
3. Ravi U, Sieg VC. Ehlers-Danlos Syndrome. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549814/
4. Milewicz DM, Braverman AC, De Backer J, et al. Marfan syndrome Nat Rev Dis Primers. 2021; 7(1).

In this episode, we provide a high-yield orthopedic review of common lower extremity soft-tissue injuries, focusing on mechanisms of injury, key physical exam findings, and first-line management. We cover common conditions such as hamstring strains, knee ligament injuries (ACL, PCL, MCL, and LCL), extensor mechanism ruptures, ankle sprains, Achilles tendon rupture, shin splints, and plantar fasciitis. The discussion highlights classic diagnostic exam maneuvers including the Lachman test, posterior drawer test, squeeze test, and Thompson test, along with red-flag conditions like compartment syndrome, an orthopedic emergency requiring immediate intervention.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. American Academy of Orthopaedic Surgeons. Diseases & conditions. OrthoInfo. Accessed March 9, 2026. https://orthoinfo.aaos.org/en/diseases--conditions/

In this episode, we review torticollis, a condition characterized by abnormal head and neck positioning caused by involuntary contraction or dysfunction of cervical muscles—most commonly the sternocleidomastoid. We discuss the various forms of torticollis, including congenital torticollis, cervical dystonia (spasmodic torticollis), ocular torticollis, and trauma-related cases, along with the neuromuscular mechanisms that lead to abnormal neck rotation and tilt. The episode highlights common clinical presentations, risk factors such as birth trauma, stress, or sudden neck movement, and key physical exam findings including lateral head tilt with contralateral rotation. We also review the role of imaging when structural or neurologic causes are suspected and discuss management strategies ranging from physical therapy and muscle relaxants to botulinum toxin injections and surgical intervention in select cases. Key clinical pearls help clinicians recognize the different types and underlying causes of this distinctive neck disorder.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Raucci U, Roversi M, Ferretti A, et al. Pediatric torticollis: clinical report and predictors of urgency of 1409 cases Ital J Pediatr. 2024; 50(1).
3. Cunha B, Tadi P, Bragg BN. Torticollis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539857/
4. Gundrathi J, Cunha B, Tiwari V, et al. Congenital Torticollis. [Updated 2024 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549778/

In this episode, we review Sjögren syndrome, a systemic autoimmune disorder that primarily affects the exocrine glands, leading to dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia). We explore the immune-mediated pathophysiology involving lymphocytic infiltration of salivary and lacrimal glands, the role of autoantibodies such as SSA/Ro and SSB/La, and the increased risk of B-cell lymphoma associated with chronic immune activation. The episode highlights common clinical features including ocular and oral dryness, parotid gland enlargement, fatigue, and a variety of extraglandular manifestations affecting the lungs, kidneys, nerves, and skin. We also discuss diagnostic evaluation with tests such as the Schirmer test, autoantibody panels, and salivary gland imaging or biopsy, along with supportive and systemic treatment options. High-yield clinical pearls reinforce how to recognize this frequently underdiagnosed autoimmune condition in both clinical practice and board-style scenarios.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Kuryata O, Lysunets T, Karavanska I, Semenov V. Duration till diagnosis and clinical profile of Sjögren's syndrome: Data from real clinical practice in a single-center cohort The Egyptian Rheumatologist. 2020; 42(1):41-46.
3. Bunya VY, Maguire MG, Akpek EK, et al. A New Screening Questionnaire to Identify Patients With Dry Eye With a High Likelihood of Having Sjögren Syndrome . 2021; 40(2):179-187.
4. Carsons SE, Blum MA. Sjogren Syndrome. [Updated 2025 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431049/

In this episode, we review reactive arthritis, an inflammatory arthritis that develops days to weeks after a gastrointestinal or genitourinary infection, most commonly associated with Chlamydia trachomatis, Shigella, Campylobacter, or other enteric pathogens. We discuss the immune-mediated pathophysiology involving molecular mimicry and T-cell activation, as well as the association with the HLA-B27 gene. The episode highlights the classic clinical presentation of asymmetric oligoarthritis of the lower extremities, often accompanied by extra-articular features such as conjunctivitis, urethritis, and enthesitis—remembered by the classic mnemonic "can't see, can't pee, can't climb a tree." We also review diagnostic evaluation, including testing for preceding infections and ruling out other inflammatory arthritides, and discuss treatment strategies focusing on NSAIDs, management of the triggering infection, and DMARDs for persistent disease. High-yield clinical pearls reinforce how to recognize this important seronegative spondyloarthropathy in both clinical practice and board-style exams.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Cheeti A, Chakraborty RK, Ramphul K. Reactive Arthritis. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499831/
3. Denison HJ, Curtis EM, Clynes MA, Bromhead C, Dennison EM, Grainger R. The incidence of sexually acquired reactive arthritis: a systematic literature review Clin Rheumatol. 2016; 35(11):2639-2648.
4. Ehrenfeld M. Spondyloarthropathies Best Practice & Research Clinical Rheumatology. 2012; 26(1):135-145.