Dr. Tehrany: A Case Study

During Dr. Wallace’s clinic, one of the golf girls came into the Athletic Training Room complaining of right shoulder pain. Dr.Wallace first began the evaluation by asking if she remembered how she hurt her shoulder. The golfer said she had been at home during winter break and was wearing socks

Type II SLAP LESIONS Alia Scriven Coppin State University KNES 427- Therapeutic Athletic Exercise September 30, 2016 Introduction Russell Carrington is a 25 year old right handed relief pitcher for the MLB team the Baltimore Orioles. Carrington has been playing baseball since he was seven years old and this was his third season in the Major Leagues. Carrington was at the mound and in the motion of throwing a fastball, when he felt a “pop” in his overhand motion. He dropped to his knees and clinched his right shoulder in pain. Athletic trainers came onto the field an upon examination Carrington stated his arm felt like it was “dead” and felt like it was “catching”. Carrington was seen by the team physician. She performed ROM exercises, strength, and stability tests on his shoulder and examined his neck and head to ensure pain wasn’t coming from a pinched nerve. She concluded that further testing and imaging was necessary. Carrington had an X-ray and MRI done on his shoulder and he was diagnosed with a type II SLAP (Superior Labrum Anterior and Posterior) lesion. He didn’t want surgery done because he would miss the remainder of the season and possibly the next, so doctors prescribed non-steroid anti-inflammatory medication and five months physical therapy to strengthen the shoulder capsule. After completion of physical therapy, the pain didn’t improve and arthroscopy surgery was recommended.

She said, she fell last night while playing volley ball. She landed on her right shoulder and heard a pop sound, too. She did not take any pain medicines. She applied icepack and felt burning pain. This was an interesting musculoskeletal assessment case. We assessed her right shoulder and compared with the left one. We found slight dislocation of the shoulder joint. She had good circulation in her right arm, no swelling noted in the right hand and the capillary refill was < 2 secs. Mary said, since she had burning pain, it could be a nerve injury, too. We also noted a slight swelling of her trapezius muscle on the right side. She complained of pain on palpation. Mary applied a sling to her right arm to keep it elevated. She may need an MRI to see the damage. Mary sent her to the urgent care. She told her that, since she heard the popped sound, the ER or Urgent care doctor can replace it. It will be a painful procedure, and she will need a strong pain medicine. She gave her the note for her teacher and asked her friend to drive her to the urgent

He also says and demonstrates that if he supports the wrist that the tip of the ulna "goes back in place" and if he holds it the pain goes away. He reports that he has a laxity in the wrist. The PA Ms. Becker went over the MRI, x-ray and the ultrasound. She said he was born with the ulna being longer, that it is not acute. The MRI did show some fluid which could be from inflammation. She said she would recommend he go to a hand specialist. Mr. Naranjo was not aware of the results of the MRI other than they were normal because he opted not to follow up with Dr. Branch. He said he did not like Dr. Branch, that he did not feel a connection. Ms. Becker would also recommend a MRI of the wrist done at Sparrow so the previous radiologist could compare it to the prior forearm MRI, She suggested Dr. Stevens a hand specialist, and she also ordered Occupational therapy to continue. Mr. Naranjo asked if she would order some pain medication since he has

HPI 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

Dr. Justin Clayton at the Mercy Clinic Orthopedic Surgery evaluated the claimant on April 6, 2018. Dr. Clayton stated the claimant may have rheumatoid disease and prescribe him Meloxicam. In addition, he reported the claimant would be referred for further arthritis evaluation (Ex. 23F).

The patient notes that the injury happen when he was lifting some metal trash trays into a trash bin when he felt a sharp pain in his shoulders. Treatment history notes that the treatment to date has consisted of medications. Of note, the MRI done showed a large full thickness tear with retraction of the tendon. Physical examination of the left shoulder revealed that the range of motion has forward flexion of 0-175 degrees, external rotation of 0-40 degrees, and internal rotation to T12. There is positive Hawkins’ and Neer’s sign for impingement. There is weakness with abduction testing. Treatment plan notes recommendation, surgical intervention in the form of a left shoulder, subacromial decompression, rotator cuff repair surgery as necessary. A follow up of 2 to 3 weeks if surgery is authorized. As per medical summary and work status dated 6/14/16, it was noted that the patient has not improved significantly and would be needing surgery. The patient’s return to work date is 6/14/16 with no lifting over 10 pounds and no overhead reach. Follow up to clinic date is on

The patient was diagnosed with bursitis of the right shoulder, pain in right shoulder, and impingement syndrome of the right shoulder.

PHYSICAL EXAM: He is in discomfort. He cannot straighten his knee out completely. He has a large bulky dressing on his knee and a brace.

DOI: 2/24/2016. Patient is a 46-year-old male production technician who sustained injury while he was lifting a heavy door when he felt immediate pain in his right shoulder. Per OMNI, he was initially diagnosed with right shoulder strain.

DOI: 4/27/2015. Patient is a 52-year-old male driver guard who sustained a work-related injury to his bilateral shoulders, hands, wrists, and back after being involved in a motor vehicle accident. As per OMNI, the patient was diagnosed with right shoulder labral tear, biceps tendonitis and impingement syndrome, acromioclavicular sprain,

The participants included 87 individuals (28 men, 49 women) with various shoulder dysfunctions who were assessed during a routine clinical evaluation and consented for shoulder arthroscopy. Also, all individuals were required to have a magnetic resonance image (MRI), to have completed the dedicated special tests of interest in the study, and to have a detailed diagnosis after arthroscopic surgery.

A physical therapy evaluation dated 08/07/2017 indicated that the claimant had a right shoulder pain after a fall onto her elbow and knee at work on 06/28/2017. She stated that she will have a surgical intervention on her right shoulder. She rated the pain at 6-8/10. She was unable to reach above her right with the right upper extremity. Objective findings showed reduced right arm swing. It was noted that the claimant was unable to place the right hand behind the head or the ear. There was a noted atrophy of the right forearm. Therapeutic exercises, moist heat, TENS, cryotherapy, and patient

DOI: 3/24/2011. Patient is a 50-year old male station manager/mechanic who sustained a work-related injury when he attempted to mount tire on machine, lost pressure, machine kicked tire, and jerked the his left arm. Patient is currently diagnosed with cervical disc bulge, cervical disc protrusion, left C6 radiculopathy, bilateral

Data: 06/03/09 Identifying Data: Name: J. Smith Sex: female Age: 44 Occupation: community college administration assistant Reliability: good CC: bilateral shoulder stiffness, right elbow pain HPI: Ms. Smith presents to the office with bilateral shoulder stiffness and lateral elbow pain in right arm. The patient has been suffering shoulder stiffness for over 2 years. The symptom developed gradually after she started using her computer more at her work place; she had to hold her telephone between her shoulder and head while typing information on computer. The pain in right elbow stated about 8 months ago with gradual onset. The patient does not recall any trauma to the shoulder and elbow. She has been diagnosed as tennis