Bone Contusion Report

SKIN: She has some mild ecchymosis on her skin, and some erythema. She has patches but no obvious skin breakdown. She has some fissuring in the buttocks crease. PULMONARY: Clear to percussion and auscultation bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, nontender, protuberant, no orgonomegaly, and positive bowel sounds. NEUROLOGIC EXAM: Cranial nerves II through XII are grossly intact. Diffuse hyporeflexia. MUSCULOSKELETAL: Erosive, destructive changes in the elbows, wrists, and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with stovepipe legs, and perimalleolar pitting edema 1 +. I feel no pulses distally in either leg. PSYCHIATRIC: Patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychologic services. She refused for now.

Per the report obtained Mr. Smith had good alignment of both ankles and his hardware was in

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O: Left Pointer Finger Nail: A Blue colored discoloration, tender to palpation; Left pointer Finger distal phalanx 1 cm in length purple discoloration, small, pin tip size open area, bleeding has stopped. mild edema

Per medical report dated 01/23/15, the patient reported of middle and lower back pain and bilateral leg pain with tingling. He was diagnosed with thoracic compression fracture and lumbar spondylolisthesis.

On examination of the right ankle, there is edema. Range of motion is limited in all planes. Dorsiflexion shows 15 degrees, flexion to 20 degrees and inversion/eversion of 10 degrees. There is tenderness upon palpation of the lateral and medial malleolus. Sensation is decreased. Atrophy/wasting is noted.

There is collapse of the medial arch with calcaneal valgus with weight bearing. The IW functions in end range pronation throughout midstance of gait. There is tenderness upon palpation to the posterior plantar aspect of the left heel at the insertion of the calcaneus. There is mild pain with deep palpation to the right foot in the same location. She has pain with dorsiflexion and plantar flexion of the dorsal aspect of the left 1st metatarsophalangeal joint. There is no pain with active dorsiflexion and plantar flexion with resistance.

The patient underwent a right foot surgery with bilobed rotational skin flap of the foot, debridement, harvesting of a full thickness skin graft at a separate site and application of a full thickness skin graft per operative report dated 5/29/15.

CM Gilmore met with Bmo and VC are several attempts to make contact to ensure safety and well-being. CM addressed the allegations in the report regarding the PKU screening of the infant. She reported that she didn't use the doctor that was recommended at the hosptial, because of the distance from her residence to the doctor's office. She reported that she changed doctors. She reported that she has been missed three appointments. Bmo was able to provide proof of immunization records regarding the required shots the child is supposed to have at her age. CM Gilmore found no safety concerns in the home. CM Gilmore discussed safe sleep with Bmo, and assessed the home, and sleeping area of infant.

A patient in the ward has been diagnosed with osteomyelitis. She recently fell the pavement, and a bus run over her right lower limb since the driver wasn’t able to stop the bus in time. The lady was taken immediately to the accident and emergency department where she underwent several clinical manifestations, none of which showed any fractures of the tibia or damage to nerves and muscle tissue.

Electrodiagnostic consultation report dated 10/02/15 revealed normal study of both upper limbs and cervical paraspinals. No evidence of cervical radiculopathy. No median or ulnar neuropathy.

Ribbing disease (RD) is a rare bone dysplasia characterized by benign endosteal and periosteal new bone formation confined to the diaphysis of the long bones of the lower extremities in young adults. (Anonymous. 2011) Surgical procedures used in the treatment of orthopedics include: Amputation, Joint replacement (arthroplasty), and Repair of torn ligaments and tendons. (U.S. National Library of Medicine. 2015) X-ray images allow physicians to look through skin and into the very bone itself, enabling evaluation and diagnosis of fractures, arthritis, foreign body, and other orthopedic injuries and conditions. (Rezin Orthopedics and Sports Medicine.

This is 24 year old WF. Patient had a broken tail bone 2 years ago/per patient report. The pain is in the lower back and buttocks. Patient also reports the pain is felkt in the pelvis. Patient states this pain is often worse with activity like climbing stairs, sitting and/or standing for a long time. Current pain 9/10.

Frowen, P., O’Donnell, M., Lorimer, D. and Burrow, G. (2010), Neal’s Disorders of the Foot,

The anatomy of the foot is very complex. There are twenty six bones in each foot. The bones in both feet equal one-quarter of the bones in the human body. There are thirty three joints and over one hundred muscles, tendons and ligaments in the foot as well. The longest bones of the foot are known as the metatarsals. There are five in each foot with the fifth being on the exterior of the foot and the first on the interior. On the end of each metatarsal there are phalanges, better known to most people as toes. The phalanges and metatarsals are the easiest to break or injure from weight bearing activities. According to the