The JBJS Journal of Orthopaedics for Physician Assistants (JOPA) continues the tradition of recognizing outstanding review articles and case studies submitted during the previous year by practicing PAs, NPs, and PA students. OrthoBuzz is pleased to spotlight the winners of the 2020 JBJS JOPA Writing Awards.
Name: Christy W. Rose, MSM, PA-C
Affiliations: University Orthopedic Surgeons, Division of Ortho Tennessee; University of Tennessee Medical Center, Knoxville
Tell us about your paper.
This paper presents 5 patients who were referred to our orthopaedic oncology clinic for atypical osseous and soft-tissue lesions or masses. Some of the lesions even appeared malignant on initial imaging, but once biopsy results were obtained, the pathology was consistent with gout. Gout is known as the “great mimicker” because it does a fantastic job of disguising itself as other disease processes. This paper highlights some of those atypical presentations with the hope that other providers will keep gout on their list of potential diagnoses when these patients present. We also cover some suggestions when working up osseous and soft-tissue masses and discuss when it is appropriate to refer to an orthopaedic oncologist.
How did you decide to write on this topic? What was the most interesting “take-away,” in your opinion?
At our institution, we treat everything from sarcomas to lipomas and everything in-between. These cases were particularly interesting to me because they were all referred to us for concerns of more nefarious diagnosis. When the patients present to our clinic, sometimes they are terrified because they were told that they had cancer even before a tissue diagnosis was obtained. These cases highlight that “nothing is certain until it is certain.” I know that this is not a profound statement, but I feel like we need to be up front with our patients and educate them on potential diagnosis, but at the same time, don’t crush their hope that something less threatening may be going on.
What do you enjoy most about your career?
My supervising physician, Dr. Anna Wallace, and I are honored and deeply humbled to have the privilege to walk with patients as they the go through their various oncologic treatments and pre- and postoperative process. These patients are so inspiring and encouraging to me because they are warriors, and they keep fighting. The outcomes aren’t always joyful (cancer stinks), but they can leave an impression on you that changes you.
How do you stay informed about new developments in orthopaedics?
I attend conferences, read journal articles, and listen to CME lectures through various apps.
What are you currently reading/listening to/watching?
My husband and I have 3 children, ages 7, 5, and 2. At home, we watch a lot of PAW Patrol, Bluey, and various Lego movies. When we are not watching something animated, we enjoy the Marvel spin-off series. When I can find time for pleasure reading, I enjoy devotionals targeted at working moms and historical fiction.
More details about the JBJS JOPA Writing Awards can be found here.
Since 2016, The Journal of Bone & Joint Surgery and JBJS Journal of Orthopaedics for Physician Assistants (JOPA) have awarded two $500 prizes to outstanding JOPA review articles or case studies written by authors who were PA students at the time of article submission.
The 2019 award winners for best articles by PA students produced high-quality literature reviews that address current and impactful topics. We recognized author Matthew Morrow, BA, PA-S out of Northwestern University for “The Effects of Cannabinoid Use on Acute Orthopaedic Pain: A Review of the Current Literature,” which showed that cannabis use provided little to no pain relief for acute musculoskeletal pain. The review also concluded that cannabis use while recovering from musculoskeletal trauma may be associated with an increased use of narcotics. The article suggests that cannabis use has a larger role for chronic rather than acute musculoskeletal pain.
Brittany Szabo, PA-S and Justin Gambini, MSPAS, PA-C, from Campbell University College of Pharmacy and Health Sciences, were recognized for “Ewing Sarcoma: A Review on Primary Bone Malignancy in Pediatrics and the Diagnosis, Treatment, and Challenges of Managing Ewing Sarcoma.” This article provided a comprehensive review of a “can’t miss” orthopaedic diagnosis, including clinical and diagnostic signs for orthopaedic providers to look for.
Congratulations to our 2019 PA student writing-award winners! We are offering two $500 awards again this year, so please encourage all of your PA students to submit an article for consideration! Deadline for submission is December 31, 2020.
And be on the lookout for an announcement about 2 additional 2019 JOPA Writing Award winners.
Dagan Cloutier, PA-C
Editor, JBJS Journal of Orthopaedics for Physician Assistants
Access the most relevant peer-reviewed orthopaedic content, including unlimited CME, by purchasing a 1-year JBJS JOPA CME membership—for the limited-time special rate of $99.
Your JBJS JOPA CME membership includes the following essential ingredients for your professional development and education:
- New JBJS Reviews CME every week
- Full access to JBJS Reviews and JBJS Journal of Orthopaedics for Physician Assistants (JOPA)
- Monthly Image Quizzes
- Annual PA Salary Survey
- Physical Exam and Injection Video Library
With more than 50 AMA PRA Category 1 CreditsTM available annually* with your membership, you can complete all your CME for under $100.
To obtain the special $99 rate, click here and enter code WHQ834AA at checkout.
*The Journal of Bone and Joint Surgery Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. JBJS designates each JBJS Reviews journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Get the answer to that question and many more in the 2016 Salary and Call Survey, compiled by JOPA, the JBJS Journal of Orthopaedics for Physician Assistants.
In addition to a US regional breakdown of average base salaries among PAs working in orthopaedics, the 2016 survey contains accurate, trending information from PAs about:
- Hospital versus Private-Practice Salaries
- Trends in Bonuses, Benefits, and Perks
- Workload and Autonomy
- Call Structures and Schedules
- Job Satisfaction
The survey was conducted by email during November and December 2016. JBJS Journal of Orthopaedics for Physician Assistants (JOPA) sent an online survey to 3,056 JOPA subscribers. Three-hundred twenty (320) physician assistants in orthopaedics responded, representing a response rate of 10%. At a 95% confidence level, results are projected at a ±5.5% margin of error.
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 55-year-old woman with neck pain and upper-extremity weakness after a motor vehicle accident that occurred 1 week prior, during which she sustained a whiplash injury. She notes severe bilateral arm weakness, “clumsy hands,” and mild lower-extremity weakness with walking. The bilateral upper-extremity muscle groups have a strength of 3 of 5, and the lower-extremity muscle groups have a strength of 5 of 5. Sensation remains intact throughout the upper and lower extremities.
Select from among four choices as the most likely diagnosis:
- Central cord syndrome
- Brown-Séquard syndrome
- Anterior cord syndrome
- Posterior cord syndrome
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 64-year-old woman who fell out of bed while sleeping and landed directly on the lateral aspect of the right shoulder. Based on the image shown here and a Zanca view radiograph, she was diagnosed in the emergency room with a lateral clavicle fracture. After staying in a sling for about two weeks, the patient continued to have shoulder pain when using the arm with overhead activities and when sleeping on the shoulder at night.
Select from among four choices as the next best step in treatment: MRI to evaluate the coracoclavicular ligaments, open reduction/internal fixation, continued sling treatment until pain resolves, or transacromial wire fixation.
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 7-year-old girl who sustained a wrist injury from a fall off of monkey bars. An initial lateral radiograph is shown here. Clinicians attempted a closed reduction and applied a long arm cast. At the 1-week follow-up visit, radiographs showed additional displacement and increased dorsal angulation.
Select from among five possible choices for the greatest predictor of fracture displacement in the setting of distal radial metaphyseal fractures: increased fracture obliquity, a cast index ratio of less than or equal to 0.7, short arm casting, an intact ulna, or increased initial displacement of the radius.
The Fall 2016 JBJS JOPA is now available. To access the new issue, go to the JBJS JOPA website, click on the journal image to the right, and download the PDF. Topics include:
- A Visual Guide to the Salter-Harris Pediatric Fracture Classification System
- Perioperative Pain Management in the Chronic Opioid User
- Radiation Safety for PAs in the Orthopaedic Operating Room
- Recap of the monthly image quizzes, including November’s quiz on Distal Radial Metaphyseal Fractures.
With your JOPA subscription, you receive complimentary access to JBJS Reviews, which delivers new online review articles weekly, with a CME opportunity attached to each article.
Create your account and gain access to these important orthopaedic resources/opportunities:
- Writing/video incentive program for PAs and NPs
- Physician Assistants in Orthopaedics: A Study of Job Satisfaction, Education and Lifestyles, A Research Brief from JBJS JOPA
- A salary and call survey for orthopaedic PAs.
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants(JOPA) presents the case of a teenage girl who dislocated her patella while playing volleyball. The quiz provides four postreduction images, two radiographs and two fat-suppressed MRI scans, and then readers are presented with two questions:
- What is the next best step in this patient’s treatment?
- Which concomitant condition does NOT cause an increased risk of patellar instability?
This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) presents the case of a 74-year-old woman with a 2-month history of left knee pain. She was given an intra-articular knee injection for presumed osteoarthritis, which failed to provide any relief. At a follow-up visit, clinicians obtained the MRI shown here.
Pick among five possible diagnoses: secondary osteonecrosis, transient osteoporosis, spontaneous osteonecrosis, osteochondritis dissecans, or bone marrow edema lesion.