Physio, MSc, PhD Fellow & Senior Research Coordinator @SORC_C, IOC Copenhagen.
Copenhagen
Joined July 2009
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Kasper Krommes retweeted
Such a fantastic case. If you are in Ortho or MSK care and don't follow James, you are missing out on interacting with one of the top diagnosticians of our time.
Consent✅ - this is a beauty 🤓
Elite runner
Crampy, aching lateral knee pain - onset at around 20-30 mins
Seen multiple clinicians - had numerous injections including ITB plus extensive rehabilitation - refractory
Almost 'claudicant' in nature - settles quickly on cessation of exercise - spreads both proximal & distal to lateral joint line
No spinal symptoms & LSp assessment clear
No lateral compartment pathology eg meniscal tear
Had popliteus tendinopathy on US, but minimal response to my initial diagnostic injection
POCUS video -
The inferolateral genicular neurovascular bundle ('pepper pot' structure) is seen compressed under the distal ITB on active knee flexion : terminal extension
Patient localises pain in this area with probe pressure
Injection - hydrodissection (CSI, LA) - fluid seen separating plane just superficial to NV bundle
100% pain relief on extended treadmill test beyond 45 mins 👍
I wonder how many recalcitrant 'ITB' cases are actually neurovascular in aetiology? 🧐
Plan - considering angiography, MR neurography & possible distal ITB release at Gerdy's tubercle if not responsive to injection
Kasper Krommes retweeted
Insertional tendon changes are typically part of apophysitides - I see this in the hamstring tendon in ischial apophysitis almost universally, calcaneal apophysitis etc etc - its part of the 'wider syndrome' (if not defined by imaging)
Into skeletal maturity, a % of OGS patients have persistent pain - possibly due to persistent insertional tendinopathy, or irritable intra-tendinous ossicle.
Kasper Krommes retweeted
Interesting that it is a common feature across different sites. Clinically, the symptoms behave very much like an insertional tendinopathy.
Kasper Krommes retweeted
Shots fired:
"Researchers should not use the “factors associated with” study design and scientific journals should not publish these analyses."
bmjmedicine.bmj.com/content/…
Kasper Krommes retweeted
I seem to have been discussing pilot and feasibility studies a lot this week. One question often asked is how big should my pilot/feasibility study be? 1/6
#MethodologyMonday #124
Kasper Krommes retweeted
🎙️New podcast: The Replication Crisis Hits Sports Science.
72% of sports science studies could NOT be replicated.
Effect sizes dropped 75%. Nearly 90% of researchers wouldn’t even share data. We explore bad incentives, a crisis of trust & how to fix it
🎧 podcasts.apple.com/za/podcas…
Kasper Krommes retweeted
Ground-breaking, still highly relevant paper established that specific health status measurement #instruments are better at detecting treatment effects – that is, more responsive – than are generic instruments.
pubmed.ncbi.nlm.nih.gov/1258…
Kasper Krommes retweeted
📢 SPIRIT 2025 Statement: Updated Guideline for Protocols of Randomised Trials. Includes:
-A new open science section
-Enhanced guidance on harms assessment and description of interventions/comparators
-A dedicated item on patient and public involvement
thelancet.com/journals/lance…
Kasper Krommes retweeted
No differences in prevalences of pubic-related radiographic findings between football players with and without groin pain!
Great to see another online paper from my PhD🤩
It is open access! 🆓 ⬇️
onlinelibrary.wiley.com/jour…
@SORC_C
Kasper Krommes retweeted
The updated SPIRIT 2025 explanation and elaboration document provides guidance on protocols of randomised trials for researchers
bmj.com/content/389/bmj-2024…
Kasper Krommes retweeted
This week saw the publication of SPIRIT 2025, a major update to the international SPIRIT Statement which provides guidance on what should be included in a trial protocol. 1/6
#MethodologyMonday #117
Kasper Krommes retweeted
This updated SPIRIT 2025 (Standard Protocol Items: Recommendations for Interventional Trials) explanation and elaboration document provides guidance on protocols of randomised trials for researchers
bmj.com/content/389/bmj-2024…
Kasper Krommes retweeted
A major update to the CONSORT reporting guidance for clinical trials was published last week.
📌 CONSORT 2025 replaces all previous versions and should be used from now on.
So what’s new and what’s different? 1/7
#MethodologyMonday #116
(COI - I am a co-author)
Kasper Krommes retweeted
🚨 Innovative approaches to injury prevention and performance enhancement in running 🏃♀️
Insights from PhD research on hamstring strengthening, running biomechanics and energetics, and wearable technology ⌚️
🏆 PhD Academy Award article from the #CurrentIssue 📄
#FREE 👉 bit.ly/4lsSRGx
Kasper Krommes retweeted
Consent ✅
Rare adolescent condition
15 yo boxer - RHD
Anterior shoulder pain with increasing sparring work & fight schedule - reduced power output & endurance
Push / press sore, throwing a punch
Belly press & Gerber's lift off test positive ++
Pain at EROM external rotation
POCUS video - apophysitis of lesser tuberosity (subscapularis insertion) - this fuses / matures around 16/17yo variably
Kasper Krommes retweeted
PhDone!
Honoured to defend >10yrs of work alongside my promotors, Prof. Kerkhoffs & Prof. @Jltol.
Massive thanks to our team, opponents, friends & family.
Thesis available here: orthopeden.org/media/01yix21…
Made possible by @ACES_Amsterdam @AMSmovement @deorthopedie, thank you!
Kasper Krommes retweeted
Big news for #EBM! Just out in #BMJ, ROBUST-RCT, pristinely developed, innovative, simple, user-friendly instrument for risk of bias assessment in #RCTs far superior to anything before, will become standard outside of Cochrane and in #Cochrane if they let folks use it.
bmj.com/content/388/bmj-2024…
Kasper Krommes retweeted
Consent ✅
17 yo footballer & sprinter
Ramp in training - worsening lower abdominal pain into medial groin / adductor region & into perineum
Initially R, then more severe L
Sprinting, change of direction / cutting, abdominal / core work provocative
Also cough & sneeze, rolling. over in bed
Clinically, pain reproduced on isometric adductor testing, resisted crunches, tender symphysis pubis
POCUS - L superior pubic apophysis fragmented / widened
MRI - marked perisymphyseal bone oedema, L > R as per laterality of symptoms, plus inflammation across L superior pubic apophysis.
So - pubic overload / pubic apophysitis
The pubic apophyses often fuse very late (up to late 20s!) versus other pelvic apophyses - so might not be on our diagnostic radar
Key is not to confuse with adductor related groin pain, which might send us down an erroneous tendon focused rehab programme
Kasper Krommes retweeted
New pilot study: Non-operative outcomes in elite athletes with a proximal hamstring tendon avulsion
SPOILER: Fast & successful return to performance
➡️Clinical & radiological data
➡️Detailed ‘rehab recipe’
➡️Mechanobiological hypothesis on tendon healing
bmjopensem.bmj.com/content/1…
