Cme Case Study On Work Related Injury

He underwent an interlaminar injection in May 2015 which improved his lower extremity pain by 99%. This has lasted him up until 1 month when he has had recrudescences of pain emanating from the low back radiating intermittently into the left lower extremity in a sharp shooting fashion, average pain 5/10, and worse pain 81/0. The pain is frequent and is associated with numbness and tingling. There is some difficulty with walking. Over the past 1 month, the pain has been severe. Home exercises and nonsteroidal anti-inflammatory medications (NSAIDS) have not been effective in reducing his pain and the pain is severe at times and limiting his ability to lift and sit. Walking, exercise and standing increased the pain. Lying down reduce the

12/24/15 Progress Report describes that the patient has right knee pain. The pain is frequent. It is aching and burning in quality. The current pain level is 0/10 and worst pain is 4/10. Bending, squatting, walking, weight bearing, changing clothes and ROM aggravate the pain. Rest, ice,

Based on the progress report dated 09/12/16, the patient reports more frequent pain with activity since the last

On Primary Treating Physician’s Progress Report (PR-2) dated 08/11/2017, the patient presented with unchanged symptoms. His left-hand pain was rated at 8/10. and was described as constant and sharp. The pain was aggravated with certain movements and gripping. The

Based on the progress report dated 02/29/16 by Dr. Naraghi, the patient reports worsening of her right lower extremity with pain, numbness and weakness.

Based on the progress report dated 04/05/16 by Dr. Fieser, the patient complains of pain in the left knee, left ankle and left foot, associated with numbness and tingling in the left leg/foot, as well as weakness in the left leg. He describes the pain as sharp, cutting, throbbing, dull, aching, pressure-like, cramping, shooting and shocking with muscle pain and pins-and-needles sensation.

Patient was diagnosed with left shoulder pain, status post rotator cuff repair on 07/12/2013, right thigh pain and chronic low back and right lower extremity pain.

Based on the latest follow-up physiatric evaluation report dated 01/11/16, the patient complains of lower back pain which improves temporarily with PT but continues to radiate to his left leg with numbness, tingling and weakness. He attends PT three days per week and participates in a daily home exercise program.

Based on the progress report dated 03/28/16, the patient complains of pain to his lumbar

Based on the medical report dated 12/15/16, the patient complains of constant pain to her neck, bilateral shoulders and bilateral knee/leg. Pain is described as sharp, stabbing, achy and

The pain has been worsening over the left buttock area associated with tingling and numbness down to the left leg. Medical treatment to date notes physical therapy and Nonsteroidal Antiinflammatory Drugs (NSAIDs) with limited improvement. Medical history and review of system notes that the patient is significant for hypertension. Examination of the lumbar spine revealed slight loss of lumbar lordosis. On palpation, there is moderate-to-severe guarding with reproduction of deep myofascial pain on deep palpation, mostly on the left side. Pain level is 7/10 at the time of examination. Range of motion revealed forward flexion of 50 degrees, extension of 10 degrees, right lateral flexion of 20 degrees, and left lateral flexion of 20

Per medical report dated 12/23/15 by Dr. Ajay Kiri, the patient is developing left-sided knee pain as a consequence and is also developing right leg discomfort with gradual improvement in pain. There is numbness and tingling sensation radiating to the bilateral lower extremities. The pain is described to

Ms. Huttunen was sent for an IME on 7/26/16. No objective findings were found to support an ongoing work injury. Mr. Andrew Rider asked for this file to be closed.

With the patient sitting comfortably on exam table his chest was clear to IPPA without adventitious sounds. Cardiovascular system: Sinus rhythm, normal heart sounds. Extremities: There are 3+ femoral pulses. There was a right hypochondrium incision. There was diminished dorsalis pedis, posterior tibial, and popliteal pulses equally bilaterally. There was no calf tenderness. There were no skin or hair changes. No nail changes. Sensation was normal. Both limbs were warm equally.

Based on the progress report dated 12/16/15, the patient reports that the pain remains in the low back and bilateral shoulders. The low back pain radiates to the bilateral lower extremities and is associated with numbness and tingling. He has worsening leg symptoms. He has not yet been authorized for his lumbar ESI. Surgery is pending for the left shoulder.