Learning EMG

[AnybodyWantAPeanut?]

Hey everyone,
PGY1 rehab resident here, anyone with advice on what book to read to basic intro into EMGs, not that i have a ton of time during intern year but wanted to have the basics down once i do start learning them, i dont wanna start with no knowledge at all besides what ncs/emgs are used for but how to interpret the waveforms, or how other specialities utilize them like latency for carpal tunnel etc.

---

Members don't see this ad.

 

[cowboydoc]

Based on your question, you're asking for the title "Easy EMG," which is EMG for dummies.

Preston and Shapiro is pretty readable and fairly good. Then read Dumitru when you're ready to be an expert, or reference it to sound like one.

 

[AnybodyWantAPeanut?]

Based on your question, you're asking for the title "Easy EMG," which is EMG for dummies.

Preston and Shapiro is pretty readable and fairly good. Then read Dumitru when you're ready to be an expert, or reference it to sound like one.

thanks, dumitru will be my EMG attending, so i dont want to look like a complete idiot when i start training with him, thanks i will get that book and read when i can.

 

[cowboydoc]

Be damn sure he never sees you with "Easy EMG," you'll never live it down. Who is attending for EMG at the VA now?

 

[j4pac]

Know anatomy cold. You should be able to march from the brain down to the muscle for every clinically relevant muscle. I’d also think about a good root screen for the brachial and lumbosacral plexus. If you can come up with 3 different muscles that correlated with three different branches for the same nerve root you have a good basis. I’d also think about common nerve entrapment syndromes...CTS, cubital tunnel, perineal neuropathy. You should be able to develop an EMG strategy for each.

Easy EMG is a good enough, and definitely readable text. But I encourage focusing on learning the anatomy of EMG before delving into the science and technical aspects of EMG.

 

[padresp]

I think there are three things to learn:
1. Technique (where to put electrodes, where to stim, how much to stim, how to properly needle, etc.)
2. Anatomy (where's the muscle, where's the nerve, what are the innervations/root levels, etc.)
3. Pathophysiology (what does low amplitude mean, when would a muscle expected to be reinnervated, where are common locations of injury, etc.)

I would probably start in that order, but unfortunately, they are not sequential. Technique is probably the best place to start. But if you don't know anatomy, it's tough. Then, if you don't know pathophysiology, you don't know what you're looking at!!

I tell my residents to start with reading the chapter on pathophysiology. Learn how nerves/muscles are injured and recover. Learn the basics of what we're looking for in an EMG. Learn the "big picture" of what we're doing with an EMG/NCS. You should always be learning anatomy throughout residency; you won't be an expert at the beginning, but knowing anatomy ALWAYS helps you in clinical practice. For EMG, knowing muscle innervations and root levels is key.

When they start the first time, we just go over where to put the stimulations, and go over what we're looking at on the screen. As they progress, we start on simple needling. Once that technique is down, then we go into putting NCS and EMG together. Finally, it's thinking on the fly and figuring out what to examine.