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Poster 347 The Effectiveness of Musculoskeletal Ultrasound for Teaching Joint Palpation to Medical Students
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Abstracts / PM R 7 (2015) S83-S222
increasing age. For females, only stride length were statistically significant (p¼.01), with increasing probability of injury with longer stride lengths. Conclusion: This is the first study that characterizes foot strike and injury rates of ultramarathon runners in a competitive race. Our data suggests that foot strike might not be associated with injuries, while stride length may be a factor influencing injury in females.
Poster 345 Cubitus Valgus - An Uncommon Etiology for Ulnar Neuropathy: A Case Report David Rustom, MD (Wayne State University/Rehabilitation Institute of Michigan/Detroit Medical Center, Detroit, MI, United States), Syed R. Ahmed, DO Disclosures: D. Rustom: I Have No Relevant Financial Relationships To Disclose. Case Description: A 35-year-old woman presented with ongoing bilateral hand paresthesias that was worse during sleep and in the seated position. She had seen multiple providers who presumptively diagnosed her with carpal tunnel syndrome. She wore bilateral wrist splints for approximately two years, and received multiple carpal tunnel corticosteroid injections. She slept on her back with the arms abducted and forearms supinated. This position exacerbated paresthesias in digits 3-5. On physical examination she had atrophy of the hypothenar and intrinsic hand muscles, along with 4/5 hand grip strength. The patient had decreased two point discrimination in the distribution of the dorsal and palmar ulnar cutaneous nerves. Further examination revealed +10 degree extension in bilateral elbows, and cubitus valgus deformity. Bilateral cubital tunnel Tinel’s sign was positive. Froment’s sign was more prominent on the Right. Setting: Secondary care consultation. Results or Clinical Course: Using AP radiographs, we calculated a carrying angle of 14.5 degrees for the left, and 16 for the right elbow. The normal carrying angle is 12.0 +/-2 degrees for females. NCS revealed bilateral prolonged ulnar sensory distal latencies, with mildly attenuated CMAP amplitudes. Using the inching technique, a 0.5 ms distal latency difference was calculated approximately 1.5 cm distal to the medial epicondyle. The abductor digiti minimi showed decreased recruitment bilaterally on EMG. We implemented lifestyle modifications limiting flexion and extension, along with 45 degree hinged elbow bracing relieving ulnar nerve entrapment. She returned to work as a hairdresser, reported a 30% score reduction in the Oswestry Disability Index and slept without pain. Discussion: The literature has not described ulnar neuropathy due to cubitus valgus, it has been attributed more commonly to varus deformities. Turner and Noonan syndromes along with supracondylar fractures are most commonly associated. Incidentally, our patient presented with bilateral deformities despite no congenital or traumatic history. Cubitus valgus has a prevalence of 3% and can be overlooked. Elbow hypermobility and prolonged extension/flexion positioning can exacerbate symptoms. Conclusion: Cubitus valgus is an uncommon, yet treatable cause of ulnar neuropathy at the elbow.
Poster 346 The Effect of a Musculoskeletal Ultrasound Course on the Accuracy of Joint Palpation in Physical Medicine and Rehabilitation Residents Samuel K. Chu, MD (Northwestern Feinberg School of Medicine/ Rehabilitation Institute of Chicago, Chicago, IL, United States), Steven A. Makovitch, DO, Maria E. Reese, MD, Christine M. Gagnon, PhD, Monica Rho, MD Disclosures: S. K. Chu: I Have No Relevant Financial Relationships To Disclose.
Objective: To determine the effectiveness of a 1-day musculoskeletal ultrasound course on the accuracy of lateral knee and acromioclavicular (AC) joint line palpation in Physical Medicine and Rehabilitation (PM&R) residents using ultrasound verification. Design: Cohort Study. Setting: PM&R residency program at an academic institution. Participants: Twenty-one PM&R residents participating in a musculoskeletal ultrasound course (8 PGY-2, 5 PGY-3, and 8 PGY-4 residents). Interventions: 1-day musculoskeletal ultrasound course utilizing direct ultrasound feedback on musculoskeletal physical examination maneuvers. Main Outcome Measures: Pre-course and post-course ultrasound verification of correct needle placement over the lateral knee and AC joint lines on a male and female physical examination model. Participants were asked to place the needle parallel to the joint line based on their palpatory exam. Results or Clinical Course: McNemar’s test was performed to compare pre-course and post-course results. Overall AC joint palpation accuracy improved from 33.3% on pre-course assessment to 52.4% on post-course assessment (P¼.115). Overall knee lateral joint line palpation accuracy improved significantly from 57.1% on pre-course assessment to 83.3% on post-course assessment (P¼.007). For the knee lateral joint line, there was also a statistically significant improvement in palpation accuracy on the female physical examination model from 33.3% to 81.0% (P¼.006), while there was no statistically significant improvement on the male physical examination model (81.0% to 85.7%). Based on the resident level of education, there were no statistically significant differences in the accuracy of joint line palpation. Conclusion: Joint line palpation accuracy of the AC and lateral knee joint line in PM&R residents is low, despite prior traditional education of musculoskeletal physical examination without utilizing musculoskeletal ultrasound. A musculoskeletal ultrasound course directed at providing residents feedback on the accuracy of their palpation skills improved palpation accuracy of the AC and knee lateral joint lines. The educational use of musculoskeletal ultrasound may be an effective method of teaching musculoskeletal physical examination for medical trainees.
Poster 347 The Effectiveness of Musculoskeletal Ultrasound for Teaching Joint Palpation to Medical Students Samuel K. Chu, MD (Northwestern Feinberg School of Medicine/ Rehabilitation Institute of Chicago, Chicago, IL, United States), Christine M. Gagnon, PhD, Monica Rho, MD Disclosures: S. K. Chu: I Have No Relevant Financial Relationships To Disclose. Objective: To determine the effectiveness of a 2-hour musculoskeletal (MSK) ultrasound and physical examination class on the accuracy of knee and acromioclavicular (AC) joint line palpation in first-year medical students using ultrasound verification. Design: Cohort study Setting: Medical school at an academic institution. Participants: Thirty first-year medical students. Interventions: A 2-hour hands-on MSK physical examination class with direct feedback using ultrasound. Main Outcome Measures: Pre-class and post-class ultrasound verification of correct needle placement over the lateral knee and AC joint lines on a physical examination model. Pre-class testing was done 1 week after the traditional medical school MSK physical examination curriculum that did not use ultrasound. Post-class testing was done 1 week after the 2-hour MSK ultrasound class was given. Participants were asked to place the needle parallel to the joint line based on their palpatory exam, and placement was verified by the MSK class instructor using ultrasound. Results or Clinical Course: McNemar’s test was performed to compare pre-class and post-class results. Overall AC joint palpation
Abstracts / PM R 7 (2015) S83-S222 accuracy improved significantly from 30.8% on pre-class assessment to 65.4% on post-class assessment (P¼.022). Overall knee lateral joint line palpation accuracy improved from 50.0% on pre-class assessment to 65.4% on post-class assessment (P¼.344). Conclusion: Joint line palpation accuracy of the AC and lateral knee joint line in first-year medical students is low after conventional MSK physical examination education. A 2-hour physical examination class using MSK ultrasound to provide direct feedback to medical students on the accuracy of their palpation skills improved palpation accuracy of the AC and knee lateral joint lines 1 week later. The utilization of MSK ultrasound is a novel and effective method of teaching the MSK physical examination to medical trainees.
Poster 348 Diabetic Cheiroarthropathy- A Musculoskeletal Complication of Diabetes Mellitus: A Case Report Roman Zolotoy (Tufts Medical Center, Boston, MA, United States) Disclosures: R. Zolotoy: I Have No Relevant Financial Relationships To Disclose. Case Description: A 52-year-old woman with a 15-year history of type 2 diabetes mellitus presented to an outpatient clinic complaining of significant joint stiffness and skin tightening over bilateral hands and fingers which has been present for 2 years. Skin tightness persisted throughout the day. Stiffness was worse at night. She denied any skin color changes of her fingers in cold weather. Patient stated that she finally decided to seek treatment due to emotional distress caused by increased difficulty with grasping the steering wheel especially on the way home from work. Examination revealed reduced range of motion (ROM) over both hands, most notably over bilateral proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. She was found to have decreased grip strength and a positive Prayer sign. Upper extremity distal pulses and sensation were intact bilaterally. Bloodwork was unremarkable outside of an elevated glucose and hemoglobin A1C levels. Patient’s glycemic control regimen was altered for better control and she was referred to outpatient occupational therapy. Setting: Outpatient clinic. Results or Clinical Course: Overall, patient progressed well and was able to improve range of motion of both hands. She was able to make functional gains of both hands culminating in restoration of her ability to grasp a steering wheel. Discussion: Diabetic cheiroarthropathy (DC) is a complication of diabetes manifested by thickened skin and reduced ROM over hands. It presents as tight, thickened, waxy skin. Most commonly affects the PIP and MCP joints. Patients may also experience pain. In the progressed state it can lead to flexion contractures and decrease in functional capacity. Although usually thought of as a complication of Type 1 DM, it is also a frequent complication of patients with Type 2 DM and can be seen in up to 40% of diabetic patients. Prayer sign and Tabletop sign help aid in the diagnosis. Hallmark of successful treatment consists of optimal blood sugar control. Stretching exercises have also been used to improve ROM and restore functional capacity. Conclusion: DC is a unique complication of diabetes mellitus. While emphasizing tight blood glucose control is vital to any treatment plan, tailored therapy program with specific stretching exercises plays a vital role in maintaining functional use of affected joints.
Poster 349 Bilateral Medial Tibial Stress Fractures in Female Monozygotic Twins: A Case Report Christopher Connor, DO (Temple University Hospital, Philadelphia, PA, United States), Jeffrey M. North, MD Disclosures: C. Connor: I Have No Relevant Financial Relationships To Disclose.
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Case Description: 16-year-old female identical twins presented with insidious onset of one-month history of anterior leg pain. Sister #1 complained of bilateral anterior leg pain (left> right), while sister #2 experienced right anterior leg pain. Symptoms began 2 weeks into their soccer season. Both complained of sharp, progressive pain with activity. Examinations were notable for bilateral calcaneal valgus, hyperpronation, along with tenderness over lower 1/3 posterior medial tibia, reproduction of pain with dynamic activity and poor stability on single limb testing. Both sisters had normal menstrual cycles. Setting: Outpatient musculoskeletal clinic at an academic medical center. Results or Clinical Course: The sisters’ bilateral lower limb x-rays did not reveal periosteal reaction or fracture. Triple phase bone scan revealed findings consistent with stress fractures involving the middle third of bilateral tibias (L> R) in sister #1 and also bilateral tibias (R> L) in sister #2. Both sisters were restricted from soccer or other sporting activity for 6 weeks. Semi-rigid medial longitudinal arch supports were prescribed to correct their hyperpronation. Upon follow up, the sisters’ pain improved and were allowed to follow a structured return to play protocol. Discussion: Stress fractures involving the medial tibial cortex present as focal pain seen most commonly in females who have a history of medial tibial stress syndrome (MTSS). Alike MTSS, the etiology of stress fractures is often multifactorial. Intrinsic risk factors include: increased foot pronation, BMI > 21 and increased hip internal/ external ROM. Furthermore, inexperienced runners, change in exercise intensity and footwear play a role in its development. In a closed kinetic chain, hyperpronation of the subtalar joint causes calcaneal eversion, forefoot abduction and tibial internal rotation, which predisposes the tibia to altered mechanical forces that may affect cortical integrity. Conclusion: This is a unique case of bilateral tibial stress fractures seen in identical twins. Also highlights the significant role of foot hyperpronation in the development of MTSS and its clinical continuum leading to potential stress fractures.
Poster 350 Verification of Platelet and Other Cells using PEAKä Platelet Rich Plasma System Ha Seon Yun (New Jersey Institute of Regenerative Medicine, Cedar Knolls, NJ, United States), Gerard Malanga, MD, Greg Hill, Undergraduate Disclosures: H. Yun: I Have No Relevant Financial Relationships To Disclose. Objective: To verify the manufacturer’s claim that PEAKä Platelet Rich Plasma (PRP) System produces PRP in three minutes with ease and consistency of cell concentrations. Design: Basic research. Setting: Medical laboratory. Participants: 1 blood donor. Interventions: 27 ml of blood was obtained twice from a donor and processed as per the manufacturers of the PEAK system’s instructions to create a 3ml PRP product. The platelets, Red Blood Cells (RBCs) and White Blood Cells (WBCs) were counted at baseline and after processing using the Cellometer X2ä Image Cytometer. Main Outcome Measures: Average number of Platelet, RBCs and WBCs per mL in PEAKä product, and fold change of cells compared to baseline. Results or Clinical Course: The PEAKä system increased platelet concentrations by a fold of 4.345 or a percentage increase of 316% resulted in an average platelet count of 1.425x10^9 cells/mL. The RBCs and WBCs counts were noted to be on average 1.41510^9, and 5.35510^7 cells/mL, respectively. The final product resulted in a WBC concentration fold increase of 2.56 or a percentage increase of 60.97% and a RBC concentration decrease of a fold of 4.35 or a decrease of 76.6%. The final PEAKä PRP products contains on average a total of 3.58510^9 platelet cells, 4.24510^9 RBCs and 1.60710^8 WBCs.
Abstracts / PM R 7 (2015) S83-S222
increasing age. For females, only stride length were statistically significant (p¼.01), with increasing probability of injury with longer stride lengths. Conclusion: This is the first study that characterizes foot strike and injury rates of ultramarathon runners in a competitive race. Our data suggests that foot strike might not be associated with injuries, while stride length may be a factor influencing injury in females.
Poster 345 Cubitus Valgus - An Uncommon Etiology for Ulnar Neuropathy: A Case Report David Rustom, MD (Wayne State University/Rehabilitation Institute of Michigan/Detroit Medical Center, Detroit, MI, United States), Syed R. Ahmed, DO Disclosures: D. Rustom: I Have No Relevant Financial Relationships To Disclose. Case Description: A 35-year-old woman presented with ongoing bilateral hand paresthesias that was worse during sleep and in the seated position. She had seen multiple providers who presumptively diagnosed her with carpal tunnel syndrome. She wore bilateral wrist splints for approximately two years, and received multiple carpal tunnel corticosteroid injections. She slept on her back with the arms abducted and forearms supinated. This position exacerbated paresthesias in digits 3-5. On physical examination she had atrophy of the hypothenar and intrinsic hand muscles, along with 4/5 hand grip strength. The patient had decreased two point discrimination in the distribution of the dorsal and palmar ulnar cutaneous nerves. Further examination revealed +10 degree extension in bilateral elbows, and cubitus valgus deformity. Bilateral cubital tunnel Tinel’s sign was positive. Froment’s sign was more prominent on the Right. Setting: Secondary care consultation. Results or Clinical Course: Using AP radiographs, we calculated a carrying angle of 14.5 degrees for the left, and 16 for the right elbow. The normal carrying angle is 12.0 +/-2 degrees for females. NCS revealed bilateral prolonged ulnar sensory distal latencies, with mildly attenuated CMAP amplitudes. Using the inching technique, a 0.5 ms distal latency difference was calculated approximately 1.5 cm distal to the medial epicondyle. The abductor digiti minimi showed decreased recruitment bilaterally on EMG. We implemented lifestyle modifications limiting flexion and extension, along with 45 degree hinged elbow bracing relieving ulnar nerve entrapment. She returned to work as a hairdresser, reported a 30% score reduction in the Oswestry Disability Index and slept without pain. Discussion: The literature has not described ulnar neuropathy due to cubitus valgus, it has been attributed more commonly to varus deformities. Turner and Noonan syndromes along with supracondylar fractures are most commonly associated. Incidentally, our patient presented with bilateral deformities despite no congenital or traumatic history. Cubitus valgus has a prevalence of 3% and can be overlooked. Elbow hypermobility and prolonged extension/flexion positioning can exacerbate symptoms. Conclusion: Cubitus valgus is an uncommon, yet treatable cause of ulnar neuropathy at the elbow.
Poster 346 The Effect of a Musculoskeletal Ultrasound Course on the Accuracy of Joint Palpation in Physical Medicine and Rehabilitation Residents Samuel K. Chu, MD (Northwestern Feinberg School of Medicine/ Rehabilitation Institute of Chicago, Chicago, IL, United States), Steven A. Makovitch, DO, Maria E. Reese, MD, Christine M. Gagnon, PhD, Monica Rho, MD Disclosures: S. K. Chu: I Have No Relevant Financial Relationships To Disclose.
Objective: To determine the effectiveness of a 1-day musculoskeletal ultrasound course on the accuracy of lateral knee and acromioclavicular (AC) joint line palpation in Physical Medicine and Rehabilitation (PM&R) residents using ultrasound verification. Design: Cohort Study. Setting: PM&R residency program at an academic institution. Participants: Twenty-one PM&R residents participating in a musculoskeletal ultrasound course (8 PGY-2, 5 PGY-3, and 8 PGY-4 residents). Interventions: 1-day musculoskeletal ultrasound course utilizing direct ultrasound feedback on musculoskeletal physical examination maneuvers. Main Outcome Measures: Pre-course and post-course ultrasound verification of correct needle placement over the lateral knee and AC joint lines on a male and female physical examination model. Participants were asked to place the needle parallel to the joint line based on their palpatory exam. Results or Clinical Course: McNemar’s test was performed to compare pre-course and post-course results. Overall AC joint palpation accuracy improved from 33.3% on pre-course assessment to 52.4% on post-course assessment (P¼.115). Overall knee lateral joint line palpation accuracy improved significantly from 57.1% on pre-course assessment to 83.3% on post-course assessment (P¼.007). For the knee lateral joint line, there was also a statistically significant improvement in palpation accuracy on the female physical examination model from 33.3% to 81.0% (P¼.006), while there was no statistically significant improvement on the male physical examination model (81.0% to 85.7%). Based on the resident level of education, there were no statistically significant differences in the accuracy of joint line palpation. Conclusion: Joint line palpation accuracy of the AC and lateral knee joint line in PM&R residents is low, despite prior traditional education of musculoskeletal physical examination without utilizing musculoskeletal ultrasound. A musculoskeletal ultrasound course directed at providing residents feedback on the accuracy of their palpation skills improved palpation accuracy of the AC and knee lateral joint lines. The educational use of musculoskeletal ultrasound may be an effective method of teaching musculoskeletal physical examination for medical trainees.
Poster 347 The Effectiveness of Musculoskeletal Ultrasound for Teaching Joint Palpation to Medical Students Samuel K. Chu, MD (Northwestern Feinberg School of Medicine/ Rehabilitation Institute of Chicago, Chicago, IL, United States), Christine M. Gagnon, PhD, Monica Rho, MD Disclosures: S. K. Chu: I Have No Relevant Financial Relationships To Disclose. Objective: To determine the effectiveness of a 2-hour musculoskeletal (MSK) ultrasound and physical examination class on the accuracy of knee and acromioclavicular (AC) joint line palpation in first-year medical students using ultrasound verification. Design: Cohort study Setting: Medical school at an academic institution. Participants: Thirty first-year medical students. Interventions: A 2-hour hands-on MSK physical examination class with direct feedback using ultrasound. Main Outcome Measures: Pre-class and post-class ultrasound verification of correct needle placement over the lateral knee and AC joint lines on a physical examination model. Pre-class testing was done 1 week after the traditional medical school MSK physical examination curriculum that did not use ultrasound. Post-class testing was done 1 week after the 2-hour MSK ultrasound class was given. Participants were asked to place the needle parallel to the joint line based on their palpatory exam, and placement was verified by the MSK class instructor using ultrasound. Results or Clinical Course: McNemar’s test was performed to compare pre-class and post-class results. Overall AC joint palpation
Abstracts / PM R 7 (2015) S83-S222 accuracy improved significantly from 30.8% on pre-class assessment to 65.4% on post-class assessment (P¼.022). Overall knee lateral joint line palpation accuracy improved from 50.0% on pre-class assessment to 65.4% on post-class assessment (P¼.344). Conclusion: Joint line palpation accuracy of the AC and lateral knee joint line in first-year medical students is low after conventional MSK physical examination education. A 2-hour physical examination class using MSK ultrasound to provide direct feedback to medical students on the accuracy of their palpation skills improved palpation accuracy of the AC and knee lateral joint lines 1 week later. The utilization of MSK ultrasound is a novel and effective method of teaching the MSK physical examination to medical trainees.
Poster 348 Diabetic Cheiroarthropathy- A Musculoskeletal Complication of Diabetes Mellitus: A Case Report Roman Zolotoy (Tufts Medical Center, Boston, MA, United States) Disclosures: R. Zolotoy: I Have No Relevant Financial Relationships To Disclose. Case Description: A 52-year-old woman with a 15-year history of type 2 diabetes mellitus presented to an outpatient clinic complaining of significant joint stiffness and skin tightening over bilateral hands and fingers which has been present for 2 years. Skin tightness persisted throughout the day. Stiffness was worse at night. She denied any skin color changes of her fingers in cold weather. Patient stated that she finally decided to seek treatment due to emotional distress caused by increased difficulty with grasping the steering wheel especially on the way home from work. Examination revealed reduced range of motion (ROM) over both hands, most notably over bilateral proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joints. She was found to have decreased grip strength and a positive Prayer sign. Upper extremity distal pulses and sensation were intact bilaterally. Bloodwork was unremarkable outside of an elevated glucose and hemoglobin A1C levels. Patient’s glycemic control regimen was altered for better control and she was referred to outpatient occupational therapy. Setting: Outpatient clinic. Results or Clinical Course: Overall, patient progressed well and was able to improve range of motion of both hands. She was able to make functional gains of both hands culminating in restoration of her ability to grasp a steering wheel. Discussion: Diabetic cheiroarthropathy (DC) is a complication of diabetes manifested by thickened skin and reduced ROM over hands. It presents as tight, thickened, waxy skin. Most commonly affects the PIP and MCP joints. Patients may also experience pain. In the progressed state it can lead to flexion contractures and decrease in functional capacity. Although usually thought of as a complication of Type 1 DM, it is also a frequent complication of patients with Type 2 DM and can be seen in up to 40% of diabetic patients. Prayer sign and Tabletop sign help aid in the diagnosis. Hallmark of successful treatment consists of optimal blood sugar control. Stretching exercises have also been used to improve ROM and restore functional capacity. Conclusion: DC is a unique complication of diabetes mellitus. While emphasizing tight blood glucose control is vital to any treatment plan, tailored therapy program with specific stretching exercises plays a vital role in maintaining functional use of affected joints.
Poster 349 Bilateral Medial Tibial Stress Fractures in Female Monozygotic Twins: A Case Report Christopher Connor, DO (Temple University Hospital, Philadelphia, PA, United States), Jeffrey M. North, MD Disclosures: C. Connor: I Have No Relevant Financial Relationships To Disclose.
S205
Case Description: 16-year-old female identical twins presented with insidious onset of one-month history of anterior leg pain. Sister #1 complained of bilateral anterior leg pain (left> right), while sister #2 experienced right anterior leg pain. Symptoms began 2 weeks into their soccer season. Both complained of sharp, progressive pain with activity. Examinations were notable for bilateral calcaneal valgus, hyperpronation, along with tenderness over lower 1/3 posterior medial tibia, reproduction of pain with dynamic activity and poor stability on single limb testing. Both sisters had normal menstrual cycles. Setting: Outpatient musculoskeletal clinic at an academic medical center. Results or Clinical Course: The sisters’ bilateral lower limb x-rays did not reveal periosteal reaction or fracture. Triple phase bone scan revealed findings consistent with stress fractures involving the middle third of bilateral tibias (L> R) in sister #1 and also bilateral tibias (R> L) in sister #2. Both sisters were restricted from soccer or other sporting activity for 6 weeks. Semi-rigid medial longitudinal arch supports were prescribed to correct their hyperpronation. Upon follow up, the sisters’ pain improved and were allowed to follow a structured return to play protocol. Discussion: Stress fractures involving the medial tibial cortex present as focal pain seen most commonly in females who have a history of medial tibial stress syndrome (MTSS). Alike MTSS, the etiology of stress fractures is often multifactorial. Intrinsic risk factors include: increased foot pronation, BMI > 21 and increased hip internal/ external ROM. Furthermore, inexperienced runners, change in exercise intensity and footwear play a role in its development. In a closed kinetic chain, hyperpronation of the subtalar joint causes calcaneal eversion, forefoot abduction and tibial internal rotation, which predisposes the tibia to altered mechanical forces that may affect cortical integrity. Conclusion: This is a unique case of bilateral tibial stress fractures seen in identical twins. Also highlights the significant role of foot hyperpronation in the development of MTSS and its clinical continuum leading to potential stress fractures.
Poster 350 Verification of Platelet and Other Cells using PEAKä Platelet Rich Plasma System Ha Seon Yun (New Jersey Institute of Regenerative Medicine, Cedar Knolls, NJ, United States), Gerard Malanga, MD, Greg Hill, Undergraduate Disclosures: H. Yun: I Have No Relevant Financial Relationships To Disclose. Objective: To verify the manufacturer’s claim that PEAKä Platelet Rich Plasma (PRP) System produces PRP in three minutes with ease and consistency of cell concentrations. Design: Basic research. Setting: Medical laboratory. Participants: 1 blood donor. Interventions: 27 ml of blood was obtained twice from a donor and processed as per the manufacturers of the PEAK system’s instructions to create a 3ml PRP product. The platelets, Red Blood Cells (RBCs) and White Blood Cells (WBCs) were counted at baseline and after processing using the Cellometer X2ä Image Cytometer. Main Outcome Measures: Average number of Platelet, RBCs and WBCs per mL in PEAKä product, and fold change of cells compared to baseline. Results or Clinical Course: The PEAKä system increased platelet concentrations by a fold of 4.345 or a percentage increase of 316% resulted in an average platelet count of 1.425x10^9 cells/mL. The RBCs and WBCs counts were noted to be on average 1.41510^9, and 5.35510^7 cells/mL, respectively. The final product resulted in a WBC concentration fold increase of 2.56 or a percentage increase of 60.97% and a RBC concentration decrease of a fold of 4.35 or a decrease of 76.6%. The final PEAKä PRP products contains on average a total of 3.58510^9 platelet cells, 4.24510^9 RBCs and 1.60710^8 WBCs.