Differential Diagnosis And Treatment Of A Patient With Posterior Upper Thoracic Pain

therapy. Wiener also provides additional resources and a list of texts that focus on the symptoms, diagnosis, and treatment of this

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.

This review of available literature will evaluate the two main forms of treatment as well as risk factors and typical barriers to care and innovations in the field of care.

Dr. Abiera had reviewed a September 3, 2010 MRI of the cervical spine that revealed central protrusion/herniation at C3/C4, left paracentral protrusion/herniation at C7/T1, Disc bulges C4/C5, C5/C6 and C6/C7, left paracentral extrusion/herniation at T3/T4 and straightening of cervical lordosis. In addition, Dr. Abiera noted an August 11, 2010 x-ray of the cervical spine which revealed blastic lesions, incidental Clay Shovelers Fractures of C7 and an August 11, 2110 x-ray of the thoracic spine which was

DOI: 9/30/2011. Patient is a 41-year-old male information technology computer support specialist who sustained injury while he was walking through a lobby when he slipped and fell. Per OMNI, he was initially diagnosed with lumbar intervertebral disc syndrome, myofasciitis and right arm strain. He underwent a right shoulder surgery on 07/16/13 and 12/22/15.

The patient was compliant to all aspects of treatment and the home exercise program. There are no known alternate explanations of the outcomes of this case report. However, in comparison to the case report by Caldwell et al25., the patient in this case report displayed a faster decrease in pain and return to normal function indicated by 0/10 VAS, 0% neck disability and ability to perform all tasks for work at the last day of treatment, 3 weeks from the first day of physical therapy. Possible explanations for the faster recovery could be due to the slight difference of impairments as well as the addition to grade IV and V manipulations to the cervical and thoracic spine as suggested to have high correlation with decrease in pain and normalization

I found case studies written from a Physician, but no resolution was written about the

It has exhibited red flags that warranted me to evaluate further and seek referral. Though it is not frequent. I am always on my toes on the lookout for anything that I find suspicious in the pathological presentation during my initial touch point with the patient. Red flags can be determined and brought to light during history and physical examination, such as patient demographics, social and health habits, medical/surgical history, medications, family history, systems review, and review of systems, physical therapists have the examination data necessary to identify the need for medical referral (Ross and Boissonnault, 2010, p. 682). A detailed history assessment preceding trauma and cervical spine tenderness with notable limitation of motion prompt consideration for immediate immobilization, referral to a specialist, and further investigation utilizing diagnostic imaging. Red flags can be used as a tool to verify the diagnosis during evaluation. However, there are times that during initial imaging, patient doesn’t exhibit any signs of red flags. That is why it is therapist responsibility to take note of all the possible symptoms that might need urgent investigation to prevent further

Each patient was subjected to four assessments. Assessment s were given at the screening, at baseline after randomization at the end of the 12 weeks treatment and size months after the end of therapy in order to evaluate the long-term effects of the treatment. Patients in the wait-list group were offered one additional assessment at the end of the 12-week waiting period. The patients were assessed by independent and trained clinicians who that had no knowledge to the treatment conditions, and who was not involved in direct clinical care of any of the

Even with active assistance, the patient can only achieve approximately 140 degrees of forward elevation, 60 degrees of external rotation, and internal rotation barely to his upper sacrurn. He has 4/5 supraspinatus weakness and pain. Internal and external rotation strength seems to be normal. He has a nonspecifically painful Neer’s, Hawkins, and O’Brien’s test. His proximal biceps and acromioclavicular (AC) joint are both very tender to palpation.

Please list the references and clinical resources that you use in your review of this document. These references should support any clinical or extensive revisions or additions that you make. If your edits are based on your own clinical experience or opinion, please indicate this. References and resources used:

On 11/21/2017, the claimant presented for a follow-up for his right shoulder. He reported right shoulder pain rated at 3/10. He stated that the range of motion had returned to normal. On examination of the right shoulder, a full range of motion was noted with resolved tenderness. The impingement sign was positive. X-ray of the right shoulder on 10/20/2017 was negative for fracture or dislocation. He was diagnosed with a traumatic arthropathy of the right shoulder. Continued physical therapy was recommended.

This case report clarified that the patient was having referred pain from the thoracolumbar region. However if this case report did have a physical therapy diagnosis written out it might look something like this:

Formulated a comprehensive patient problem list, synthesize an effective diagnostic and therapeutic plan and established

The Anterior Thoracic Nerves 1 is part of the thoracic region in the spinal nerve that originates thoracic vertebrae 1 (T1). When T1 is not functional and there is limited activity in the upper extremity, it causes a debilitating condition called scapular winging. The muscles affected are serratus anterior, trapezius, and rhomboids. Loss of function of the Anterior Thoracic Nerves 1 would affect the antagonist muscles of Shoulder Medial Rotation (Serratus anterior, Trapezius, and Rhomboids), not the synergist muscles that create the movement (Pectoralis major, Subscapularis, Latissimus dorsi, Teres major, and Anterior deltoid).