Joint Pain Case Studies

The physical Assessment Findings: The patient’s head, eyes, ears and nose are normal, however there is white patches on the buccal mucosa. The lymph nodes and carotid bruits are absent. Her heart beat at a regular rate and rhythm without murmur. Her lungs sound is diminished to auscultation with end expiratory wheezes, and dull percussion to the right lower lobe. Her anterior-posterior diameter of the chest wall is also increased. Her abdomen is benign. She has strong pedal pulses to all extremities without edema.

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

PAST MEDICAL/SURGICAL HISTORY: As above. SOCIAL HISTORY: Status post heavy smoking, 50+-pack-year history. He quit 10 years ago. Status post alcohol abuse, quit 3 or 4 years ago. He lives by himself and no longer drives but has 2 daughters here in Miami who take him where he needs to go. FAMILY HISTORY: Patient’s wife died 14 years ago of COPD due to lifelong smoking. Brother has diabetes mellitus. Unremarkable family history otherwise. REVIEW OF SYSTEMS: No fever, no nausea, no vomiting. Patient has incontinence of bowel. No shortness of breath, no chest pain, no palpitations. PHYSICAL EXAMINATION: Well-developed, well-nourished white male who is alert and oriented x3. Wears bilateral hearing aids. Afebrile with blood pressure 130/70. NECK: No carotid bruits. LUNGS: Clear to auscultation bilaterally. HEART: S1, S2 normal. No murmur. No S3 or S4. ABDOMEN: Soft, nontender. No arterial bruits. No masses, no organomegaly. EXTREMITIES: No edema. No pulses present in the lower extremities. The right great toe is absent. The left great toe shows a 2 x 1 cm deep ulcer with redness around the toe with pus extruding. PLAN 1. Get consult with Dr. Beth Brian, Infectious Disease. 2. Follow up with Dr. Hirsch, Orthopedics. (Continued)

Mr. .J. is a 30 year old Caucasian male presented to the Emergency Department with symptoms of myalgia, fever, rash, swollen glands, leukopenia, and thrombocytopenia. Mr. J. reported fever and sore throat started about a week ago and the rash presented today. Mr. J. stated “I thought I had the flu but I am not feeling any better and now I have a rash, that’s why I decided to come to the E.D.”. (Health and Human Services panel, 2013)

On admission, Ms. Pilkey subjectively described her pain as being rather excruciating. There were times when she had to curl up into a ball due to pain during the week prior to admission. Her headaches felt like a “stabbing pick which penetrates her head” that is not localized to a particular region. The initiation of topiramate on July 31st 2015 has helped. The frequency, duration and degree of pain from chronic daily headaches had reduced considerably, allowing Heather to have a better quality of life. However, the degree of cognitive impairment, manifested in difficulty understanding commands and word finding have been more pronounced. In addition, she often forgot to take her morning dose of topiramate due to the cognitive deficits

This is a 51-year-old female with an 11/4/2013 date of injury, when she slipped and fell on a wet floor landing on her buttocks.

The patient is 67-year-old gentleman who was discharged from a nursing home 2 days ago after 3 months stay. The patient had a right ruptured quadriceps tendon which was repaired in a Morris Town hospital and he was in the Atrium of Wayne for rehabilitation and discharged home. Since being discharged home he has presented himself three separate times to the emergency room, the final one being on 6/10 here at St. Joseph's where he was admitted. He presented the previous day and he was discharged. The patient presented because his right leg was collapsing while using a walker. CT done in the ED of his right knee shows that he has severe tricompartmental arthritis and loose bones. The patient is in severe pain and he is unable to ambulate. The patient lives alone in his own home. The decision was made that the safest thing was for him to be admitted acutely inpatient to try to sort through the issues that have led up to this point. No arrangements have been made for him to have any outpatient therapy. or any from the Atrium at Wayne. His medical history is significant for having previous cardiac caths. He developed MRSA infection after a quadriceps rupture in Morristown. He has allergic reactions to Metformin (not quite sure what the reaction is). As previously stated he lives alone in a home in Totowa. Physical therapy evaluation reveals the patient is not safe ambulating with a walker and obviously needs intervention. He will need some type of assistive help in the home or long-term care. After much discussion the Atrium agreed to take the patient back while we work through the issues of how he could be cared for in a

frequently locating the first-class direction of motion regarding your joint suffering may comprise maintaining a diary to file all your experiences. A clinical journal is a best method to pinpoint the motives that intent essentially the most affliction bearing on your joint problems, as good as establish the style of atmosphere or pursuits that brings out the pleasant on your body.

Joint pain usually occurs as a result of a traumatic injury or an underlying health condition. However, joint pain can also occur due to the weather changes, especially when the weather gets colder during winter.

Chronic pain is often concurrent with depression and many agents used for the treatment of depression are CYP2D6 inhibitors which interfere with the metabolism and pharmacological action of tramadol, a common agent used in the treatment of moderate to severe pain. The case reported is proposes caution should be taken in initiating or titrating tramadol in patients currently taking medications with strong CYP2D6 inhibition properties, especially in combination with other serotonergic agents. A 70-year-old female presented with signs and symptoms of mild serotonin toxicity resulting from an increased tramadol dose in concurrence with bupropion and sertraline therapy. The offending agents, tramadol and bupropion, were discontinued eliminating

On admission, the body temperature was 39ºC. Physical examination revealed an ill-appearing well-developed girl with mild pallor, and anicteric sclera. The patient had right upper quadrant abdominal tenderness with no distension or hepatomegaly. Relevant laboratory data included white blood cell count of 13.780/μL with 78% neutrophils; hemoglobin, 10.9 g/dL and C-reactive protein was 325 mg/L. Liver function tests, blood urea nitrogen and electrolytes were within reference ranges. Chest radiograph was normal.

Case Description: A 25 year old healthy male who is a very active running back in the sport of football came to the emergency room. The patient has a history of previous

Patient attends with complaints of leg pain for a period of about 1-1/2 weeks. Pain is so severe that he has to keep active, the more active he is the less the discomfort bothers him. He finds that sleeping at night really is uncomfortable because of the cramping in his legs, the cramps start in the base of his feet and run up into the calves, but again, if he gets up and is active it seems to reduce the discomfort considerably. His joints have not been red, or hot, or swollen. He has not had his limbs buckle or give way. He has not tried any medications for this. Interesting to note that he has started jogging some three weeks ago, and the discomfort in his shins is subsequent to that. He did not temporize that activity. The patient is concerned that he was on methadone and he knows that this can cause bony structure problems, dental problems. He was on it for about a year and he has been off of that now for at least two years. He is also concerned about his weight. He states he used to be 200 pounds he is now down to 160 pounds. Chart review shows that since he has been incarcerated in Faribault his weight has been pretty stable running between 155-165. I reassured him that this

Top 5 Misconceptions About Joint Pain Summary: There are many reasons behind joint pain. This is why many misconceptions about joint pain have also risen over the years. You need to visit and expert doctor to know the real cause behind your joint pain problem. Main Content: The problem of joint pain has increased among people over the years. There are a lot of misconceptions about joint pain which majority of people believe in.

I decided to come back real quick before I go in there and get to rest now this is a request video regarding pain around the knees yes a lot of you are having pain around the knees you might want to get it checked out to see if you have any cartilage and maybe nut bones rubbing together bone to bone which is not good and not then you're probably doing some type of strenuous work and you need to give your kneecap or your patella arrest so I have a simple recipe that I use normally in the evening time because you want to leave this poultice on your area either it's your elbow or your knees for eight hours so what better way to sleep and let your body rest while it's healing naturally now it would help