Smoley, Christopher

Objective: Technique description and verification of L5 pars interarticularis (L5PI) using diagnostic ultrasound (DUS).

Methods: Asymptomatic 10-year-old male subject was scanned with diagnostic ultrasound applying a linear array transducer (8–13 MHz) over L5/S1 facets; long-axis slide cephalad to capture both superior (SAP) and inferior articulating process (IAP) of L5. Contiguous hyperechoic cortex with deep acoustic shadowing between the SAP and IAP was assumed to be L5PI. To confirm in vivo technique representing L5PI, two spine models (plastic, human spine) were scanned to verify authors’ assumption. Metallic paperclip was placed over L5PI then DUS image captured. Lastly, a subject with known spondylolysis was imaged and sonographic appearance of L5PI compared.

Results: The structures localized with the metal paperclip on L5PI models were equivalent to the in vivo DUS image. Spondylolysis demonstrates an abrupt step-off defect at L5PI.

Conclusion: We report the first technique description and verification of the L5PI using DUS.

Chiropractic clinical internships at Northwestern Health Sciences University begin early in the program’s curriculum.  It is a hands-on learning experience that enhances students’ technical and patient care skills.  How this internship program was developed was presented. 

The clinical assessment strategies for chiropractic internships occurring within the campus and community-based clinic environments were discussed.

Clinical assessment is a systematic process used by mental health professionals to evaluate a patient's functioning in multiple areas. Construct-aligned scales are based on milestones that were set down by the Accreditation Council for Graduate Medical Education in the United States. Construct-aligned scales have categories showing increasing independence and sophistication in the domain being assessed.