He told me I didn’t have Patellar tracking disorder I just had a bruised bone, and there was nothing I could do to help with the pain. I decided to go to a different orthopedist, and get another opinion especially since the other doctor gave me the wrong diagnosis at first. After reviewing my MRI this doctor confirmed that I did have a bruised bone, but it wasn’t the reason for my pain since it was on the back part of my knee. He suggested that I try a cortisone shot which would help with any inflammation I had. I received the shot in the middle of June 2016, and haven’t had any pain since July. If the cortisone shot didn’t work I would have had to have arthroscopic knee surgery which would have put me even further behind in school. Thankfully
i. When discussing osteoporosis, the bones that automatically come to mind are the wrist, spine, and hip. Certain parts of the vertebral column are also common osteoporotic bones. In the vertebral column, the upper lumbar, lower thoracic, and cervical vertebrae are usually the bones that end up becoming osteoporotic.
The first patient I witnessed was a 25 year old female. Pertinent patient medical history is anxiety, depression, and sleep dysfunction. The referring diagnosis is Chondromalacia of the right patella, which is also known as runner’s knee, is a condition where the cartilage on the undersurface of the kneecap deteriorates and softens. The physician who referred the patient, Victor N. Egwu, MD, orders the PT to evaluate and treat three times per week for four weeks. Right knee ROM and strengthening exercises should be done to treat patient. The PT evaluation justification history includes 1-2 person factors examination is addressing three or more elements. The clinical presentation is stable. The clinical decision-making is low co-morbidities.
On 1/16/17 I met Mr. Anderson at the office of Dr. Rampersaud. Mr. Anderson drove to the appointment. He uses 2 canes to walk. He reports that he and his wife drove to Florida on 1/4/17 to 1/15/17. He said they walked everyday while he was there. He reports his pain is a 9. The pain is in the left Si and caudal along with the low back. Mr. Anderson is scheduled for several injections today after we meet with Dr. Rampersaud. Mr. Anderson’s current medications were discussed. I remind Dr. Rampersaud that we are on a tapering process with the medications. Mr. Anderson was instructed to decrease the Dilaudid to 3 times per day from 4; the
Based on the progress report dated 08/23/16, the patient complains left knee pain upon walking. Discomfort was described as aching, tingling, intense, severe, continuous, pain, discomfort, increasing with movement and varying with activity. Pain is rated as 5/10 without medications and 4/10 with medications.
and long, thick pins are inserted lengthwise into the bone tissue. The pins are held in place by
Based on the progress report dated 03/02/16 by Dr. Ozaeta, the patient has had a right knee corticosteroid injection one week ago. She had to take a Norco yesterday for right knee pain. She saw Dr. Cantrell, who requested 8 additional physical therapy sessions. She has low back discomfort, notable when sitting. She takes nortriptyline and an antihypertensive.
Health History: A 25-year-old male injured his left knee in a recent skiing accident. The patient stated that he lost his balance because the inner edge of his right ski got caught while skiing. This resulted in the right leg being externally rotated followed by and audible “pop” as he lost footing. By evening, the right knee joint had become swollen, causing intense pain. The primary care physician referred the case to an orthopedist.
Osteoporosis is a disorder of bones that affects bones making them low in bone mass fragile and will lead to bone fracture. Bone fracture will easily occur as this disease cause the matrix inside the bone become weak and brittle.Bones can become so brittle due to activities such as coughing can cause fractures.According to Macgill (2015) the origin of the word osteoporosis explain the condition of ‘osteo’ is for bone and ‘porosis’ means porous that resulting in weakness. At this condition, the bone tissue is mineralized normally, but the production is not enough to preserve the normal skeletal architecture. 80% of women and 20% men of 28 million American are affected with the osteoporosis. Approximately, women with the age of 50 will develop osteoporosis. Thin bones are the cause of 1.5 million fractures a year. As in Malaysia, the statistic shows that osteoporosis related to fractured is the common health problem especially in elderly..
As stated earlier, the patient admitting challenge was right total knee replacement related to history of osteoarthritis as evidenced by unrelieved pain. Osteoarthritis (OA) is a disease that “results from cartilage damage that triggers a metabolic response at the level of the chondrocytes” (Lewis, Dirksen, Heitkemper, Barry, Goldsworthy & Goodridge, 2011, p. 1881). As it progress, it causes the cartilage to become “dull, yellow, and granular” instead of being “smooth, white, translucent” (Lewis et al., 2011; Gulanick & Myers, 2014, p. 1881).As a result, it eventually becomes softer, less elastic, and less capable to resist wear during heavy use. Moreover, as the “central cartilage becomes thinner, cartilage and bony growth increases at the joint margins … that results to uneven distribution of stress across the joint” that contributes to a decrease in motion. (Lewis et al., 2011; Gulanick & Myers, 2014, p. 1882). According to this patient, OA has been giving her pain for about two years that lead her to the decision of having the knee replacement.
Every person was created to love and to be loved, and that is why so many people search desperately for a sense of belonging. In Salvage the Bones, by Jesmyn Ward, Esch embarks on a twelve day journey to discover how love between two people should really be. A healthy love is unconditional between partners and must be mutually represented through their words and actions. Esch matures as she learns that true love is equal, and as a result, she rejects her relationship with Manny to indulge in the genuine love that others, like Big Henry, has for her. However, before all this, she had to identify her harmful relationship with Manny, learn from Skeetah and China what mutual love looks like, and acknowledge that Big Henry truly loved and cared
Although I have not shadowed an osteopathic physician, my experience within the field of osteopathy derives from a more personal experience. As the patient of an osteopathic physician, I am most fascinated with the multiple modalities that my physician uses within her practice. Throughout my course of visits, I have witnessed that her practice encompasses an integrative approach in which treatments include, but are not limited to, osteopathic manipulative medicine, traditional medications and surgery. I have also noted that my primary care physician always obtained a comprehensive view of current symptoms as well as lifestyle practices. I believe that these two views allows her to detect any interconnections and assess any underlying causes
Regarding the case above I would follow up with an investigation on Susie unexplained bruises as I wouldn’t like to make a conclusion without more evidence to support this case. I would like to know how often she gets punished for not performing well in school and this information would come from Susie. I like to know if the family is able to provide enough basic needs for children and their parents. I would like to understand their culture for me to be able to work effectively.
Your discussion about vertebral augmentation procedure is very informative. It clearly delineates the difference between vertebroplasty and kyphoplasty.
HISTORY OF PRESENT ILLNESS: David Lockman is a 44-year-old male who injured his right knee on July 21, 2015 when a circular saw came into contact with his medial right knee. He was taken to the operative suite by Dr. Lin for an emergent irrigation and debridement. He tolerated this very well. He was admitted overnight for antibiotic coverage, and discharged with instructions to weight bear as tolerated with the use of a hinged knee brace and walker. He was doing well but presents today with ongoing pain of 6-7/10. His biggest concern was that the swelling, redness, and edema was now extensive down the leg and into the ankle and foot causing him some ankle pain, as well. He has been using Norco for control of his pain. He is not taking any antibiotics currently. He is set up for
The patient may also complain of crepitation being heard during movement due to irregularity of the joint surfaces in the knee gliding over one another. Knee osteoarthritis is characterized by structural changes in the knee seen on radiographs involving loss of articular cartilage, joint space loss, and the presence of osteophytes.3 Primary care providers is the ones who primarily manage osteoarthritis with conservative and pharmacological treatments. Conservative treatment consists of exercise, strength training, and weight loss in order to reduce pain and progression of the disease. However, many conservative treatments fail over time and pharmacological treatment is needed to reduce pain in the patient.1 This literature review will look into the knee portal techniques, corticosteroid injections, and hyaluronic acid injections for knee