Primary Diagnosis: Disorder of bone/cartilage.
Secondary Diagnosis: Obesity.
This was a Reconsideration- Disability Hearing Unit (DHU) case, stated his medical condition was worse than ever before.
41-year-old male alleged sarcoidosis of skin and lungs, severe depression, lumbar facet syndrome, degenerative joint/disc disease (neck, lower back, bilateral knees). Limited range of motion left shoulder, morbid obesity (6’2” and 291 pounds), chronic lower back pain, lumbar spondylosis, osteoporosis (knee). Insomnia, sleep apnea, asthma, allergic rhinitis. Elevated cholesterol, vitamin B deficiency, gastritis, recurrent folliculitis/prurigo nodularis.
Reporting health issues: Had difficulty with all personal care and all activities of
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Per pulmonary function tests, his condition was stable. Degenerative disc disease lower back and neck, lower back pain. Degenerative joint disease right knee. Right and left knee scope in 2008, right knee scope in 07/2010, decreased range of motion bilateral knees. Independent with activities of daily living. Mood disorder, depression, panic attacks.
Education: 1 year of college completed in 1991.
Work history: After Military service he tested phone lines and installed computers.
CDR Primary Diagnosis: Disorder of bone/cartilage. Secondary Diagnosis: Obesity.
Medical Records Information: Swollen lower extremities, tender to palpation lower back, right knee and left shoulder. Limited range of motion neck and lower back. Unable to squat, unable to walk on heels and toes. Asthma, sleep apnea, obesity (11/21/2014 weighed 304.4 pounds), diagnosed with rheumatoid arthritis. Was receiving mental health treatment for major depression and chronic pain in the lower back and legs, pain was “becoming intolerable.” Also reported anxiety.
Comments: It seemed that there was no improvement in the claimant’s
An MRI was performed of the lumbar spine. The examination found no significant extra
This is a 47-year-old male with a 2/1/2007 date of injury, who injured his low back from lifting a large bucket of cut grass. DIAGNOSIS: 1. Left SI radicular symptoms. Lumbar discogenic pain with high-intensity zone at L5-S1 per MRI April 2007. X-ray showed 4-mm retrolisthesis at L5-S 1.
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
He has no Romberg 's sign. IMPRESSION: History of chronic inflammatory demyelinating polyradiculoneuritis. The strength and sensation of his extremities continues to improve after this, with no recurrence of symptoms from this with weaning off of Imuran. PLAN: Continue off of Imuran. Continue observation from a neurological standpoint.
Activities at home and work worsen the pain. Numbness, tingling, and burning sensation are reported with increased pain throughout the week. The patient is requesting medication refills and reports limitations with gripping, grasping, pushing, pulling, and lifting 10 pounds. Activities of daily living are limited due to pain, as
Robbie and the team reviewed his HRST. According to the HRST, Robbie's medical diagnosis are exostosis of the medial malleolus, hypothyroidism, benign hand tremors, allergies and hypercholesteren. Robbie is under physician care for all diagnosis. He is currently prescribed four medications.
Gait Markedly antalgic. Equivocal Romberg. DTRs 2+ in the upper extremities and knees, trace at the ankles. Labs/Studies CAT scan and C-spine are as noted
R/s Mr. Schubert is diagnosed with anemia, chronic knee pain, hypertension, gout, and chronic back pain. R/s it was reported that Mrs. Schubert had gallbladder surgery a couple a weeks ago. R/s it was reported that Mr. Schubert
This is a 25 year old African American male who is here because he is experiencing burning secsation with urination, and irritation at the penus. Patient is also requesting stuture removed form his right hand. difficulty with Patient denies chest pain, SOB, N/V/D, or fever. Patient denies depressive moods, thoughts of suicide or homicide. current pain
On examination of the back, there is tenderness upon palpation midline of the lower lumbar and sacral region. Posture shift is to the left.
Issues She has Type II diabetes. Due to her compromised immune system, it is more likely that her injuries will take her longer to heal. Daily stressors and financial responsibilities may cause health concerns to take second priority. As a result, health issues
• Patient Information: -Name/Gender/Race: Valentina Palmero/Female/Caucasian -DOB: 12/4/1992 -Age: 24 years -Date of exam: 4/12/17 • Chief Complaint: Night sweats and unexplained weight loss. Patient says she has recurring episodes of extreme perspiration, soaking her clothes and bedding during sleep. Patient also notes that she has been losing weight for no apparent reason, dropping 10 pounds in a month. • History of Present Illness: The patient is a 24 year old female complaining of night sweats, unexplained weight loss as well as chronic fatigue and pruritus. Patient has noticed that her lymph nodes in her neck are swollen, but they are painless.
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.
This PTA has more than ten years of experience working as a physical therapist assistant at outpatient rehab clinics. The PTA has previous treated numerous patient with those specific diagnoses that she is now
The patient was diagnosed for polyps and multiple diverticula at the age of 68. The Patient suffers of painful osteoarthritis of both knees, shoulder hips. Patient?s mother deceased at the age of 79 from breast cancer and her father deceased at the age of 54 from heart attack. The patient noted with bilateral lower extremities edema, and claimed that she uses 2 pillows as a comfortable position to sleep,