Volume 111, Issue 10

Stuttering is a speech disorder characterized by a disruption in the fluency, timing, and rhythm of normal speech. It affects approximately 5% of children at some point in their lives. Although dysfluency often resolves before adulthood, it may cause periods of extreme anxiety for patients, especially those who continue to stutter in adolescence and adulthood. Although these patients are unlikely to stop stuttering, treatment options are available to reduce anxiety and therefore the severity of symptoms. In the present review article, the authors discuss the pathophysiology, diagnosis, and management of developmental stuttering in children and adults.

The number of colleges of osteopathic medicine (COMs), osteopathic medical students, and osteopathic physicians in practice has been consistently growing since the 1960s. In recent years, the growth of the profession has been exponential. Despite this growth, graduates of COMs are increasingly choosing allopathic residencies. The authors believe that this trend may stem from a lack of focus on osteopathic principles and practice in COMs, as well as geographic and specialty limitations of available osteopathic residency positions. The present article will briefly examine the history of AOA accreditation and the current accreditation process and the current state of osteopathic predoctoral education and postdoctoral training. The authors call on osteopathic physicians to help bring osteopathic distinctiveness to osteopathic predoctoral education by mentoring and volunteering at COMs. In addition, the authors urge the osteopathic profession to increase the number of osteopathic residencies to account for the number of and distribution of osteopathic medical school graduates.

Sacral stress fractures are uncommon injuries that are associated with repetitive load-bearing activities. The authors describe a 23-year-old male cross-country runner who presented with low back and buttocks pain. Radiographic findings were unremarkable, but a hop test identified a sacral stress fracture. The patient was instructed to stop running and to take calcium and vitamin D supplements. Four months later, his symptoms completely resolved and he began running again. The authors also present a review of the literature, which revealed that patients with sacral stress fractures are likely to have normal neurologic examinations and full active range of motions. However, they will likely describe discomfort with passive hip flexion. The authors recommend the hop test for patients with this type of history and these physical examination findings. If a sacral stress fracture is found, treatment regimens should consist of 4 to 6 weeks of rest with gradual return to activity.