Bill is a 34-year-old male that appears to be in good health. He is very active and enjoys running and different water sports like swimming, water ski, and scuba diving. Approximately seven months ago he travelled to Puerto Vallarta for vacation. Bill mentioned that on that vacation he was taken to the Emergency room after felling sick after being scuba diving. Recently he has been having discomfort on his left hip, he complained of having stiffness and pain in his left hip for couple of weeks. So, he visited his doctor and he was evaluated. He was given an analgesic and a muscle relaxant and was given an appointment to return in 3 weeks back for a follow up. His second visit to his doctor his symptoms were not better and actually he now …show more content…
The doctor did found abnormalities on both of his hips and was considered to be serious. Bill was diagnosed with Avascular Necrosis. (AVN), Aseptic necrosis, ischemic necrosis or the most popular name it has adopted is Osteonecrosis - is death of the bone tissue due to lack of blood supply. Background of Case Study Avascular necrosis has many other names, Aseptic necrosis, ischemic necrosis or the most popular name it has adopted is Osteonecrosis - is death of the bone tissue due to lack of blood supply. Avascular necrosis was discovered months later due to his discomfort of his hips and shoulder that there was something wrong in his hips and along with the sign and symptoms and the work up the doctor performed and found. AVN is the …show more content…
According to emedicinehealth.com “The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.” Specific to this case Bends is when a diver goes in to water most likely the sea for scuba diving, the diver will have a pack of air supply and allows them to go deep in to the waters and allows them to breath with no difficulty. The body is not use to the atmosphere deep in the water where there is different pressure. The blood is more soluble this means the elements can dissolve in the blood stream, including helium, nitrogen, and oxygen. Divers need to make sure they do not ascend to the to he surface too quickly since this can create a great number of bubbles in the blood soluble gases. This will accumulate in the muscles and will cause pain and the symptoms are excessive cough, chest pain, dizziness, paralysis, difficulty breathing, unconsciousness, and even death. Bends can lead to other serious problems and one of them is avascular necrosis. AVS will progress with time passes without having any signs. The signs of are not evident fast and they take up to a year to feel the signs. As the bone is dying
An MRI was performed of the lumbar spine. The examination found no significant extra
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
Jimmie Bowman was seen in followup for CIDP, causing previous weakness and numbness of his distal lower extremities. He states that the strength of his distal lower extremities [____] continues improved and is staying normal. He has occasional mild feeling of numbness of his feet, but states this is staying down to what he can tolerate. He is not having pain of his feet. He is no longer on Imuran.
There is decreased sensation of the left anterior thigh. He has forward leaning stiff gait with ability for heel and toe rise.
Per progress report dated 10/23/14 medicatiosn include Atenolol, Norco and cyclobenzaprine. Based on progress report dated 07/06/15, the patient presents with chronic right knee pain, described as dull and achy. Pain is worsened by sittlng,standing, and walking, and relieved by walking/exercise. He has been weaning norco and flexeril.
Patient states that plays football an in Nov. 14 the patient states he was blocking a player when the player ran into his right hand with his face mask on. After her his injury the patient states he has had three x-rays in which all were negative. However, the patient states he continues to have swelling, pain that radiates to his thumb, pinky finger and wrist. Also the patient statesthat he has a lump in the middle of his hand. The patient states that he had a MRI schedule at his college by he had cancel it due to traveling.
He was a known heroin user and was in and out of treatment. You were able to see the track marks in both of his arms. His skin was cyanotic, pale and clammy, along with pinpoint pupils. The ALS provider struggled to get an IV due to the long term drug abuse, so his veins were not adequate. Also, there wasn 't a clear report on when the patient was last seen at his baseline and responsive.
This article presents a case report about a 31 year old male patient, a teacher at a university, who started experiencing mid back pain after weightlifting one day.3 About 3 hours after weightlifting, the patient began to feel sharp back pain, at levels T4-T8. His pain began to worsen that night causing muscle spasms of his paraspinal muscles, with intermittent radiating pain to his lateral thorax and chest.3 This patient had been diagnosed with thoracic facet injuries in the past, and just assumed it was that.3 However, after the pain did not subside the patient went to his physician who claimed the patient was just having muscle spasms and needed myofascial release.3 However, a radiograph was also done that revealed end plate degenerative changes at T7-T8.3 The patients clinical evaluation revealed muscle spasms of the paraspinal muscles between T3-T12, tenderness to palpate between T6-T8, full shoulder ROM, 5/5 shoulder muscle strength, and normal distal pulses and sensations.3 The patient was diagnosed with thoracic pain and muscle spasms and was give muscle relaxants and exercises for myofascial release.3 Three days after the physician visit, the patient decided to do some walking, to work on his cardio, and experienced mild shortness of
He previously had facet joint injections but only with short term good benefit. He continues to take ibuprofen and Robaxin as needed. On examination of the lumbar spine there is pain on palpation over the lumbar paraspinals. Range of motion was full.
Based on the medical report dated 06/24/16 by Dr. Angermeier, the patient presents for evaluation of left hand numbness and tingling. She has history of left ulnar nerve decompression approximately 6 years ago. She also has history of both left upper and lower
All health providers describe neck strain radiating down his shoulder. He had physical therapy three times a week for 6 months but still experienced pain at the end of 2012 to the beginning of 2013 when his physical therapy ended. DHD referred him to Dr. Katzman who discussed the need of surgery to his left shoulder which he didn’t have because no fault cut him off. He also had an MRI of his cervical spine and
Discussion Post Week Eleven NURS6551, N-6 As an advanced practice nurse (APN), one will evaluate many patients with musculoskeletal and endocrine conditions. Therefore, the clinician must be aware of subtle differences that occur in various diseases to ensure proper diagnosis and treatment. For the purpose of this week’s discussion, I will choose a case study and explain the likely diagnosis along with the differentials.
Patient has had progressive pain, numbness, and weakness in both lower extremities. He has had an epidural, physical therapy, and medications. It was reiterated that the patient has lost over 30 pounds. He has clear-cut instability as documented by the pars fracture and the spondylolisthesis, which is mobile on flexion/extension films.
He had a pituitary tumor removed, an operation on his knee and metal pins placed in his hips. And his jaw was split into fine pieces in order to be expanded because of the acromegaly. Doctors Notes • Swelling of right knee. • Ulcerated sores on lower left leg. • Abnormal hormone levels.
Muscular pain muscle spasms, restless leg syndrome, pins and needles, buzzing, numbness, electrifying pain, tearing pain, poking pain, hammering, biting,