DOI: 11/20/2015. Patient is a 26-year-old male laborer who sustained injury while he was moving a 12 x 12 timber with a co-worker when the weight shifted to his end, causing him to fall backwards and the timber struck him. Per OMNI, he was initially diagnosed with right knee contusion.
MRI of the right knee without contrast performed on 12/10/15 revealed extensive contusion/nondisplaced fractures of the femur, tibia and fibular head, partial/subtotal tear of the anterior cruciate ligament (ACL) and suprapatellar and intra-articular joint fluid. No acute medial or lateral meniscal tear is noted.
Based on the latest medical report dated 12/28/15, the patient reports right medial knee pain, described as aching and frequent. Associated symptoms
DOI: 10/3/2013. Patient is a 51-year-old male bottling machine operator who sustained injury to his left knee when he hit it on an L-bracket after he stepped over a conveyor belt, missed a stool, and fell over. The patient underwent a left knee arthroscopy on 3/31/14.
Patient reports left knee pain history of MVA in 2009 and injured left knee. Patient also reports tooth ache 4/10.
Health History: A 25-year-old male injured his left knee in a recent skiing accident. The patient stated that he lost his balance because the inner edge of his right ski got caught while skiing. This resulted in the right leg being externally rotated followed by and audible “pop” as he lost footing. By evening, the right knee joint had become swollen, causing intense pain. The primary care physician referred the case to an orthopedist.
DOI: 12/28/2014. Patient is a 31-year-old male rebar installer who sustained injury while he was installing a rebar when he twisted his right knee. Per OMNI, he was initially diagnosed with right knee strain/sprain. MRI showed positive for a tear and he underwent surgery on 02/10/15 and subsequent MRI revealed teat versus scar tissue and he underwent right knee arthroscopic lateral meniscal debridement and synovectomy on 12/22/15.
12/24/15 Progress Report describes that the patient has right knee pain. The pain is frequent. It is aching and burning in quality. The current pain level is 0/10 and worst pain is 4/10. Bending, squatting, walking, weight bearing, changing clothes and ROM aggravate the pain. Rest, ice,
MRI of the left ankle and foot obtained on 01/26/16 showed evidence of moderate to high-grade partial tear of the anterior talofibular ligament and moderate partial tear of the calcaneofibular ligament. There is evidence of mild partial tear of the deltoid ligament. Mild to moderate osseous contusion of the talar body is seen. There is a mild sinus tarsi edema. There is a minimal subtalar and tibiotalar effusions.
Per PA Alford, your MRI of left knee shows a chondral defect, osteoarthritis at the patellofemoral compartment with a focal near full-thickness chondral defect at the trochlea. Osteochondral injury at the medial femoral condyle, with a 1 cm area of partial-thickness chondral defect and subchondral bone marrow edema. No meniscus or ligament tear.
Based on the medical report dated 03/31/16 by Dr. Schonwald, the patient reports pain in his low back, left lower extremity, right lower extremity, as well as in his left hand that originates at his left elbow and to his fingertips.
DOI: 10/17/2012. Patient is a 54-year-old male janitor who sustained injury while emptying water out of bucket after mopping when he struck his right knee on a metal mop ringer. Per OMNI, he was initially diagnosed with right knee contusion.
The patient has difficulties ambulating stairs. Her pain is waking her up at night. She failed to improve with the plethora of conservative treatment entailing physical and acupuncture therapies, activity modifications, home-type exercise, injections, medications. On physical examination, the patient is utterly uncomfortable. She ambulates with antalgic gait. Well healed incisions are noted on the left knee. Patellar crepitus noted on the flexion and extension of the right knee with medial and lateral joint line tenderness more so in the medial side. McMurray's test is positive medially. Patellar crepitus is noted together with pain in patellar compression. Patient’s Voltaren gel was refilled. Patient was recommended to undergo right knee arthroscopy with partial meniscectomy and lateral patellar release surgery. She failed to improve with above mentioned conservative treatment. Any further conservative treatment will be of no benefit. Patient was also recommended 12 PT sessions for the right knee
Patient is here today with continued swelling of his right knee and restriction of range of motion. Otherwise, he has no other major complaints. Other health problems include elevated PSA, benign prostatic hypertrophy, hypertension, coronary artery disease status post stenting, CABG, and gout with swollen right knee.
Lim SY and Peh WCG (2008) : Magnetic Resonance Imaging of Sports Injuries of the Knee : Annals Academy of Medicine; 37(4) :354-361.
PHYSICAL EXAM: The patient's exam is essentially unchanged from 48 hours ago with patient reluctant to move the knee through a range of motion. There is effusion of the knee and diffuse nonlocalized tenderness. Knee is grossly stable with stress testing at 0 and 30 degrees with varus and valgus stress as well as
DOI: 2/25/2016. The patient is a 38-year old male full-time lot attendant/porter who sustained a work related injury to his left knee due to twisting knee while walking down ramp after parking car. The patient is subsequently diagnosed with sprain of unspecified site of left knee, subsequent encounter. As per office notes dated 7/22/16, the patient returns for a follow up. The patient states that since the last visit, he stayed the same. He rated his pain as 3. Then patient is taking his medications as prescribed. He notes no adverse medication reaction or side effects. The patient is currently working at full duty. Physical examination revealed that the [patient appears to be in mild pain. Left knee examination revealed that superficial swelling
Per AME report dated 5/5/2014, future medical treatment should include MRI of the right hip and lumbar spine, EMG and nerve conduction study, use of oral and topical analgesics and home stretching exercise program. Per the supplemental report dated 9/19/2014, patient was declared permanent and stationary. Attached is another Supplemental to the AME report dated 03/11/15.