Femoral stretch test: to check if the nerve is impinged 9. Gait pattern: I. Due to conditions like spasticity and contractures the hip range of movement decreases and causes the hip to slightly excessively flex during the gait cycle.\ II. Due to hip abductor weakness, the patient acquires trendelenburg gait. Imagery diagnosis 1.
The patient has been on Ultram, chronically. The patient had a primary total knee arthroplasty in 1993, a first revision in 1998, and a third revision in 2001. The patient stated that his pain has been gradually worsening for a year to the point that he can no longer do his job. He cannot sit, stand, jog or jump. He not only has knee complaints but also problems in his lower back, bilateral feet and his lefts shoulder.
DOI: 09/26/2010. The patient is a 63-year-old male route sales representative who incurred a work-related injury to his left foot and ankle due to repetitive job duties. Based on the progress report dated 03/18/16, the patient presents for reevaluation of his left ankle. He underwent left ankle surgery on 10/15/13. His left ankle has been worse the past two months.
DOI: 05/21/2015. Patient is a 52-year-old male control operator who sustained an injury to his low back after lifting 42-pound rolls. Patient is diagnosed with lumbar isthmic spondylolisthesis, lumbar degenerative disc disease, lumbar foraminal stenosis, and lumbar radiculopathy. MRI of the lumbar spine dated 09/01/15 showed L5 to S1 pars defects with mild spondylolisthesis. There is a 4.5mm generalized disc bulging and redundancy of the disc annulus with impingement of existing L5 nerve roots at neural foraminal level, right greater than left.
DOI: 12/18/2014. The patient is a 56-year old male route sales representative who sustained a work-related injury to his lower back due to slip/fall on black ice while walking from his truck. As per OMNI entry, he was initially diagnosed with lumbosacral sprain. MRI of the Lumbar Spine without Contrast dated 01/23/2015 showed lumbar spondylosis at L1-2 though L5-S1 discs. At L4-5, there is a 4-mm posterior osteophyte-disc complex more prominent laterally and on the left side.
DOI: 4/25/2014. The patient is a 37-year-old male laborer who sustained a work-related injury to his wrist, left elbow, ribs, and head when the ladder he was on collapsed. MRI of the right knee obtained on 01/26/16 revealed the following: medial meniscus: Grade 2 mucinous change, posterior horn; discoid lateral meniscus; anterior cruciate ligament (ACL) partial tear; medial cruciate ligament (MCL) thickening due to sprain or stress change; 1.5 cm osteochondral lesion at the medial femoral condyle with differential diagnosis that includes osteochondritis dissecans versus old osteochondral impaction fracture; medial femorotibial joint space narrowing; and Patella chondromalacia grade 1/2. Urine drug screen result dated 06/28/2016
Another systematic review looked at the effect of acupuncture on many chronic pain conditions, which included low back pain, tension-type headache, migraine, knee osteoarthritis, fibromyalgia, abdominal scar pain, postoperative pain, and procedural pain during colonoscopy. This review compared the response in groups treated with true acupuncture, sham acupuncture, and no acupuncture found a small but statistically significant difference between true acupuncture and sham acupuncture when used to treat various types of chronic pain conditions in favor of true acupuncture. However the effect of placebo acupuncture varied significantly, and there was a great amount of heterogeneity when comparing placebo acupuncture to no acupuncture.4 A meta-analysis
Complete rectal prolapse is a life-style altering disability that commonly affects older people. Rectal prolapse occurs when a mucosal or full-thickness layer of rectal tissue slides through the anal orifice. Full-thickness prolapse of the rectum causes significant discomfort because of the sensation of the prolapse itself, the mucus that it secretes, and because it tends to stretch the anal sphincters and cause incontinence. Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation, whereas in patients with concurrent genital and rectal prolapse, an interdisciplinary surgical approach is required. Rectal prolapse frequently coexists with other pelvic floor disorders,
These techniques are; full-endoscopic posterior foraminotomy versus microsurgical anterior decompression and fusion (Sebastian et al., 2008). The latter is commonly used in case the patient has a radicular arm pain which led to the cervical disc herniation. The former is used as the alternative for the latter when the lateral localization of the patient's pathology. An experiment was carried out on one hundred and seventy-five individuals who had undergone full-endoscopic posterior or a microsurgical anterior cervical discectomy. After the surgery had been conducted, the researchers found that 87.4% of the patients had no more arm pain while only 9.2% reported some occasional pain.
The Body Silent, by Robert Murphy, was published in 1987. The story is about Murphy’s personal account of the physical and social changes he underwent after becoming a quadriplegic. Robert Murphy was an anthropologist at Columbia University. In his early career, he spent a year observing indigenous tribes in the Amazon with his wife. In 1972, Murphy experienced a muscle spasm that was later realized to be a symptom of a growing tumor in his spinal column stretching from the C2 vertebra to the T8 vertebra, leading to partial paralysis; he underwent a few surgeries to reduce the size of the tumor, but eventually his paralysis spread until he was fully quadriplegic in 1986.
DOI: 12/17/2011. Patient is a 52-year-old male pasteurizer machine operator who sustained injury when he slipped and fell while climbing up the ladder. Per OMNI, the patient has undergone right carpal tunnel release and decomp0ression on 11/06/15, epidural steroid injection, gastro endoscopy and left knee surgery. Per the AME report dated 6/2/15 stated that future medical care includes orthopedic consultations for exacerbation, as well as short courses of physical therapy and/or prescription medication. Repeat surgery should be left open for the right wrist, as well as the possibility of surgical intervention for the bilateral shoulders and bilateral knees.
Upon examination of the radiograph, Erlenmeyer’s flask deformity was observed as well as a fracture. The patient was diagnosed with neuroblastoma at six months old where he was given treatment with cyclophosphamide and monthly intravenous bisphosphonate therapy. The bisphosphonate therapy was discontinued because of the risks associated with developing osteoporosis. After diagnosis of EFD, this patient underwent several tests to rule out potential causes of EFD, such as, bone marrow disorder, metal poisoning, or hereditary bone diseases. Radiographic images confirmed delineation between osteopetrotic and normal bone which suggested a period of increased bone turnover followed by improved bone growth which is consistent with the bisphosphonate exposure the patient had at six months old.