L4-5 Radiculopathy Case Summary

On Exam:  BP today was 140/86. Head and neck exam was all clear. She had no oral or nasal ulcers. She had no lymphadenopathy or bruits. Heart sounds were normal and the chest seemed clear, as did the abdominal exam. Musculoskeletal exam disclosed widespread Heberden's and Bouchard's nodes. She had no swelling or stress pain at the MCPs. She was not tender at the CMC joints. She had no swelling in the wrist, elbows or shoulders. She had no soft tissue tender points. She has bilateral knee crepitus but only slight instability and no effusions. She had actually good range of movement of both hips. She was tender in the lumber spine and has a scar at the lower lumbar spine from her previous operations. Her feet are somewhat flat with tenderness across the

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 is a 35-year-old male with a 9/18/2015 date of injury. The IW sustained the injury, while she was on a business trip in Seattle. She got robbed and ran after the robber in her business suit and high heel, tripped while running, and fell on to her right knee, left elbow and left hip. Her knee took the grunt of the fall and she has scrapes on her elbow and hip.

Based on the progress report dated 08/23/16, the patient complains left knee pain upon walking. Discomfort was described as aching, tingling, intense, severe, continuous, pain, discomfort, increasing with movement and varying with activity. Pain is rated as 5/10 without medications and 4/10 with medications.

DOI: 4/01/2015. The patient is a 53-year-old-male old carpenter /foreman who sustained a work- related injury while lifting a high beam when the beam slipped before being placed into the ground pushing him between the beam and leads, crushing his right ankle and foot.

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.

Exam was 5/5 in the upper extremity and right lower extremity. She had 5-/5 of her left quadriceps. Tone was normal. Sensation was intact to primary modalities.

At today's visit she is found in her room sitting in her recliner. She reports chronic, intermittent, dull, achy, lower back pain. Her current pain regimen is effective for her pain according to the facility staff. The staff reports that the patient is sleeping more hours during the day. She has increased generalized weakness. No acute distress noted this visit.

As per office notes dated 5/4/16, the patient is seen for bilateral elbow pain and bilateral wrist pain. She rates the pain as 3/10 with medication and 7/10 without medication. She is active for at least six hours a day and has energy to make plans. Her activity level has

The patient is a 48-year-old individual who sustained an injury on 09/20/16. During that time, he was running food on a plastic tray plate at work when the plates suddenly jammed to his left hand.

DOI: 11/16/2010. The patient is a 60-year-old female floor person who sustained a work-related injury when she slipped and fell on unknown slippery surface.

Based on the medical report dated 03/25/16, the patient continues to have significant headaches and bilateral neck and shoulder pain. IW has numbness and tingling in both arms with neck pain.

The patient is a 63-year-old female mess attendant who sustained a right knee injury on 2/8/2013 when she tripped and fell at work.

Based on the medical report dated 02/02/16, the patient complains of ongoing low back pain radiating into the right lower extremity with numbness, tingling and dysesthesias despite therapy and epidurals. He engages in a home exercise program.

Some reasons I would likely refer for C5 radiculopathy would be if the patient has a fracture. Unexpected weight loss, or history of cancer. Fever, chills, night sweats, or known drug use. If symptoms resonate in the lower extremities as well causing bowel and bladder dysfunction. Severe limitations during AROM in all directions of neck. Drop attacks, dizziness, and lightheadedness due to neck movement. Positive cranial nerve signs, and blood pressure about 160/95 mm Hg. Resting HR over 100 BPM and resting respiration rate over 25 bpm. Sever fatigue. If you are unable alleviate any symptoms within 2 weeks.