Cortisone Case Study

~Chief Complaint: The patient c/o bulging to the right shoulder possible dislocation with 7/10 localized pain x2 day. The patient states that when she woke up Tuesday she had right shoulder pain with mild swelling and bulging that appear to be her bone. The pain states that she is able to move he arm but it is extremely pain. The patient states that she has been taking Advil and icing her shoulder with very little improvement. She denies possible injury or numbness and tingling in the right arm or hands

DOI: 12/19/2012. Patient is a 52-year-old female laborer who sustained injury to her neck, back, and right shoulder due to motor vehicle accident. Per OMNI, she underwent an emergency neck surgery with 5 screws at C5-7 and back fusion and rod placement at T8-10.

DOI: 02/27/2014. The patient is a 63-year-old male driver who sustained lower back injury while unloading foods and fell between the loading dock and rear trailer.

DOI: 9/18/2000. Patient is a 59-year-old female technician who sustained a work-related injury due to being jostled and jolted in the back of a golf cart which ran over a pothole. As per OMNI, she was diagnosed with post cervical protrusions, facet syndromes with headaches, lumbar facet syndrome and status post right shoulder repair/resection.

DOI: 3/24/2011. Patient is a 47-year-old male station manager/mechanic who sustained a work-related injury to his neck, back, bilateral shoulder, right elbow and left wrist when he was mounting a tire and the tire kicked back.

The patient wants to also update me as far as the arm pain he mentioned last time. He says his left arm is feeling better now. He is noticing that his right shoulder is hurting at times, especially in certain positons such as while he is sleeping and if he has his arm raised over his head while he is lying down. He had no specific injury or trauma. He is not aware of anything that makes it better or worse. He is not using any medication for it thus far. He would be interested in having

Based on the latest follow-up evaluation progress report dated 03/02/16, the patient complains of right shoulder pain and stiffness. He states that his shoulder feels sore. He states that his pain is aggravated by the cold weather and over activity. The patient has not attended physical therapy for some time due to travel outside of the country. He is using an analgesic cream.

DOI: 6/23/2015. Patient is a 44-year-old male assembler who sustained injury while he was reaching for a part, pulled axle from rack and felt pain in the cervical spine. Per OMNI, the patient is diagnosed with acute cervical sprain and cervical radiculopathy.

Per the IME report on 4/28/16 by Dr. Pierce Ferriter, the patient reports that he is actively treating with physical therapy and chiropractic treatment at a frequency of 3 to 4 times per week. The patient’s diagnoses include resolved lumbar strain, resolved cervical strain, resolved left shoulder strain and resolved right knee strain. There is no medical necessity for further physical therapy, orthopedic treatment of diagnostic testing based on examination.

DOI: 9/4/2014. The patient is a 51-year old male paint maker who sustained a work-related injury when he missed a step on a platform and fell, jarring his back. As per OMNI entry, he was diagnosed with lumbar sprain and lumbosacral disc degeneration.

Based on the progress report dated 03/10/16, the patient complains of continued pain over the lateral epicondyle. He has completed 3 PT sessions to date with no improvement. Pain is radiating from the elbow towards the shoulder and hand, rated as 8/10. Review of systems is positive for joint pain and bronchitis.

Diagnoses are cervical radiculopathy, right shoulder pain, nondisplaced fracture of the greater tuberosity of the right humerus and right shoulder bursitis. He has reached maximal recovery for his right shoulder. MD is concerned that the elbow and hand pain are related more to his neck as he has a history of cervical radiculopathy and his symptoms are more of tightness than pain that can be localized. He has had epidural injections in the past for left sided radiculopathy. An updated MRI is requested. If there are right-sided findings, he will be sent for possible injection for the upper extremity pain. Otherwise, he will be sent for a second opinion for his continued

S: In 10/22/2014, TM was seen for bilateral shoulder pain. Today TM is here complains of left shoulder pain. According to TM he was aligning a Santfa, a process involving reaching. When he was bring his arm down, he felt the sharp, tearing pain in his anterior of his shoulder. TM is here with left shoulder pain. TM reports his pain at 6-7/10. The pain was sudden, sharp at The pain was localized, and didn’t radiated to anywhere else. The pain was so sudden and so severe, it scared him. TM denies any tingling or numbness, loss of movement.

DOI: 5/31/2016. Patient is a 58-year old male foreman who sustained a work-related injury to his neck, back, and pelvis due to a motor vehicle accident.

The first was a questionnaire for symptoms, disability, and the SF36 health survey. The second assessment was performed by a blinded orthopaedic specialist and third an ultrasound and MRI of the shoulder. In the first stage the subjects took a Nordic- style questionnaire that focused on pain in the upper limb. The second stage was performed by an experienced orthopaedic specialist. The specialist assessed both shoulders by determining the range of motion and pull force at a 90 degrees of abduction in the scapular plane. A constant score was calculated for both shoulders. If the constant score was below normal female values, their shoulder was considered abnormal. Third a blinded musculoskeletal radiologist performed an ultrasonography of both shoulders in all subjects. If they had an inconclusive finding they completed the assessment with an MRI. The subjects were not allowed to report any pain they were having during the