ipl-logo

Lasegue Case Studies

387 Words2 Pages

DOI: 6/10/2014. The patient is a 38-year-old male assistant lead who sustained a work-related injury to his low back after lifting a 50-pound bag of soy crisp. Based on the progress report dated 03/03/16, the patient complains of pain from the lumbar spine radiating into the left leg and foot. Pain level is 7/10. The pain is constant and the symptoms have increased with the colder temperatures. The patient complains of tingling sensation on the outside of left leg. The pain increases with prolonged standing, sitting, and walking. He also complains of pain and inflammation on the right lower quadrant of his abdomen. He is following up with his primary care physician (PCP) for further diagnostics. Patient states he continues to experience symptoms …show more content…

Lordosis is decreased. Lasegue’s is equivocal, bilaterally. There is positive straight leg raise at 70 degrees, bilaterally, eliciting pain in L5-S1 dermatome distribution. Physical exam reveals tightness and spasm of the paraspinal musculature, bilaterally. There is hypoesthesia at the anterolateral aspect of foot and ankle of an incomplete nature noted at L5, and S1 dermatome level, bilaterally. There is weakness in the big toe dorsiflexor and big toe plantar flexor noted, bilaterally. There is facet joint tenderness at L3, L4, and L5 levels, bilaterally. There is muscle weakness and deficit over anterior abdominal wall. There is tenderness over left inguinal area with positive cough impulse. Diagnoses include lumbar spine strain/sprain rule out radiculitis/radiculopathy, secondary to herniated lumbar disc L3-4 and L4-5, status post prior laminectomy discectomy, 1998, with full recovery, left inguinal lymph nodes, symptoms of gastritis nonsteroidal anti-inflammatory medication (NSAIDS) related, left ankle strain/sprain rule out internal derangement and anxiety and depression. As of this report, the patient has reached MMI with 20% whole person impairment per AME report by Dr. Brourman, dated 1/18/16. Future medical care is indicated up to 20 sessions of physical therapy, medications, epidural steroid injections and possible lumbar spine

Show More
Related
222 Words | 1 Pages

As per medical report dated 4/26/16, patient’s presenting problem started 14 days ago. Pain is still present in her right knee. Movement worsens symptoms.

Read More
366 Words | 2 Pages

DOI: 2/6/2003. The patient is a 46-year old female aide who sustained a work-related injury to her low back while she was transferring a high school student from wheel chair to table. MRI of the lumbar spine dated 2/19/16 revealed T12-L1, there is no focal posterolateral right disc protrusion; L1-2, no posterior disc protrusion/osteophyte complex; L2-3 , no posterior disc protrusion/osteophyte complex; L3-4, there is lateral left disc protrusion/osteophyte complex; L4-5, there is an approximately 3 mm posterior disc protrusion/osteophyte complex; and L5-S1, there is mild posterior disc/osteophyte complex.

Read More
256 Words | 2 Pages

IW was diagnosed with left posterior tibial tendon dysfunction/tendinosis with valgus deformity of the left heel as a result of the posterior tibial dysfunction, status post left foot reconstruction, posterior tibial tendon using flexor digitorum longus tendon transfer and left calcaneal osteotomy 05/24/11 and status post surgery on the left foot 10/15/13. Treatment plan includes x-rays of the left ankle and referral back to Dr. Ghalambor for consultation regarding his increased left ankle pain. Current request is for 1 X-ray of the Left Ankle between 3/23/2016 and

Read More
448 Words | 2 Pages

She did complain of some left face problem, left neck pain, headache, left shoulder and arm pain. She was seen in the emergency room for this. Her neck CAT scan revealed decreased disk space height at C5-6, C6-7, but no fractures. Head CAT scan was normal. She presented to her PCP couple of days later complaining of uncoordinated gait, headache, nausea, and her left arm being "on fire".

Read More
160 Words | 1 Pages

Patient is not able to jump. Patient in general with moderate hypermobility of her general joints and slightly decreased her general muscle tone control.

Read More
351 Words | 2 Pages

DOI: 06/05/12. Patient is a 50-year-old male construction laborer who sustained a work related injury to his back due to lifting heavy objects off a conveyor. Based on medical report dated 5/0115, the patient complains of severe, and on and off middle and lower back pain with difficulty with all activities. Pain is described as constant, burning, aching, dull, sharp, throbbing and tingling.

Read More
310 Words | 2 Pages

Equal weakness noted bilaterally; hands and feet are cool to touch; no clubbing noted. Patient has +1 pitting edema that extends to the mid-calf. Geriatric Depression scale score > 10, indicating mild depression Patient’s current medications include metformin (Glucophage), insulin human regular (HumuLIN R), warfarin (Coumadin), furosemide (Lasix), carvedilol (Coreg), captopril (Capoten), potassium (KDur), thiamine (Thiamilate), multi-vitamin (One-A-Day), trazadone (Desyrel), moxifloxicin (Avelox), amiodarone (Cardarone), and a nitroglycerin patch (Nitro-Dur). ECG revealed that the distal two thirds of the left ventricle was akinetic. Cardiac Catheterization revealed 80% occlusion of the left coronary artery and severe diffuse disease of the left anterior descending

Read More
889 Words | 4 Pages

Primary Diagnosis: Affective (mood) disorder. Secondary Diagnosis: Personality disorders. 22-year-old male alleged “Schoemabbs’s kyphosis,” binocular vision disorder, psychosis. Reporting health issues: Reported stiffness with sitting and pain after standing for a prolonged time.

Read More
1410 Words | 6 Pages

Her PCP order radiographs and an MRI both which appeared unremarkable.2 Due to the negative radiographs, her PCP referred her to an orthopedic who linked her back pain to lifting boxes at work, prescribed analgesics, and referred the patient to physical

Read More
1054 Words | 5 Pages

She complained of gradual development of painful swelling and erythematous skin rashes over her face, neck, hands, chest and upper back. She also complained of gradual difficulty rising from sitting, climbing stairs and combing her hair. Symptoms progressively increased over time and she was unable to carry out her daily chores. She described symptoms of progressive dysphagia for solids. There was no history of weight loss, fever, and shortness of breath, oral ulcers, arthralgia, and

Read More
457 Words | 2 Pages

DOI: 6/10/2014. Patient is a 63-year-old female assistant store manager who sustained injury when she twisted her right ankle while coming out of the back room. As per OMNI notes, she was initially diagnosed with right ankle sprain. MRI of the right ankle done on 1/19/16 showed chronic Achilles tendinitis without evidence of tear and without evidence of posterior tibial tendon tear.

Read More
894 Words | 4 Pages

He opts for the chiropractic care and seeing the massage therapist. We agree that if he is not better in several visits he will see his primary care doctor. We discuss that imaging is not indicated at this point as the pain is reproduced with palpation of the area and the exam is essentially normal. Clinically it is reasonable to assume that subjectively and objectively the area is a strain and would likely resolve in a 5-7 days. The patient consents, he is treated in our office and receives chiropractic care and massage therapy and leaves the office “feeling better” and the pain now being “+4/10”.

Read More
2354 Words | 10 Pages

Introduction Diagnostics is one of the cornerstones of physiotherapy, in fact of medical and paramedical practice in general, and it constitutes the starting point for any possible treatment strategy. A diagnosis rarely provides complete certainty, and especially in primary care, making a diagnosis and determining variables that can be treated is difficult. During the course of the first consultation the physiotherapist will develop one hypothesis, or several, about possible diagnoses. Subsequently, this hypothesis (or hypotheses) will be tested. During such a first consultation, a patient will usually provide a history, indicating the symptoms they are experiencing and a request for help.

Read More
254 Words | 2 Pages

Thank you for organising the MRI of Ms Mackintosh lumbar spine. I understand that she was recently refused assessment by the MSK team at Chelsea and Westminster Hospital. I appreciate that her symptoms are complex. However, they have worsened recently resulting in her reporting that sitting is painful so too is walking for extended periods, which have impacts on both her ability to work and participant in her hobbies. I am concerned as she requires multifactorial investigation and management she may get bounced around from one apartment to another.

Read More
279 Words | 2 Pages

The patient is an 84-year-old female who had a history of a fall approximately 2 weeks ago. She was seen in the ED at St. Joseph 's in Wayne at which time she had right hip and pelvic x-rays and also a CT of the of the hip. There was some question as to whether she had developed a fracture or dislocation of a previous hip prosthesis. The patient was in excruciating pain and was having difficulty ambulating. Her medical history is significant for diabetes mellitus, hypertension, Alzheimer 's disease, right hip fracture surgery back in January 2014.

Read More

More about Lasegue Case Studies

Open Document