Right Wrist Pain Case Studies

Raney was experiencing any pain to the area and Mrs. Raney replied that the only pain is in the right shoulder. Mrs. Raney was able to supinate and pronate her right wrist 30-40 degrees. Her skin was dry. Dr. Mendelson replied that at this time Mrs. Raney no longer required to wear the wrist brace and she can use the extremity. Dr. Mendelson obtained x-rays of her right shoulder as Mrs. Rainey has limited range of motion. After reviewing this, Dr. Mendelson replied that Mrs. Rainey as tremendous arthritis in her shoulder. I inquired if it was traumatic arthritis and the result of the accident. Dr. Mendelson replied that it was not related directly to the accident necessarily but her shoulder was aggravated from the accident. Dr. Mendelson continued to state that symptomatically it will get better and at some point Mrs. Raney did have a glenoral crack. Dr. Mendelson inquired about how Mrs. Raney’s shoulder was prior to the accident and she stated that it was fine and she could raise her arm above her shoulder and head but now she can’t and has had limited movement since the accident. Dr. Mendelson assessed and evaluated her lower extremity and replied that Mrs. Raney’s left incision is now healed. Her right ankle is still healing, the wound is dry and her skin is consolidating over the area. Mrs. Raney has an avagus external rotation of her foot.

The clinical signs of this fracture are swelling and pain in the scaphoid region, tenderness in the “anatomical snuffbox”, pain on axial compression, pain while pronating the hand, and painful pinch grip2. Radiological diagnosis consists of a scaphoid series of X-rays: Anterior-Posterior, lateral, semipronated and semisupinated views2. In cases of so-called "occult" fractures, the fracture is not visible on the radiographs, if the clinical signs are highly suggestive of fracture a 2 week period of cast immobilization is recommended, followed by a repeat X-ray series2. If further investigation is required, CT and MRI scans can also be implemented.

DOI: 6/12/2014. Patient is a 59-year-old right-handed male machine operator who sustained work-related injuries to his right arm, shoulder and neck when his right hand got caught in a mixer. As per office notes dated 9/6/16, the patient returns complains of continued neck pain with burning hot pain extending into the forearm down to the hand along the C6 and C7 distribution with numbness and tingling in the hand. The patient has undergone multiple medications, physical therapy, TEN both in physical therapy and home use. It was also noted that the pateint denies having cognitive behavioral therapy. The provider notes, that it would be appropriate as based on the history including postoperative right forearm fracture repair and forearm open reduction and internal fixation of the right distal radius that an additional surgery to the right arm and continue physical therapy, yet continues to have swelling

This is a 28-year-old male with a 3/17/2015 date of injury. He sustained the injury, when 6 sheets of sheetrock fell on his leg.

DOI: 2/25/2014. Patient is a 23 year-old male laborer who sustained a work-related injury to his right hand index finger, middle finger, and ring finger when they got caught in the mixer paddle. As per OMNI entry, the patient underwent open reduction fixation on 3/4/2014 and another surgery for removal of pins, skin graft, and debridement on 06/2013.

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

DOI: 9/26/2015. Patient is a 29-year-old male construction worker who sustained a work-related injury to his neck, back, left shoulder and right knee when he slipped and fell. He is status post left shoulder arthroscopy on 8/05/2016.

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.

DIAGNOSIS: Strain of muscle, fascia, and tendon at neck level; Carpal tunnel syndrome, unspecified right limb,;Carpal tunnel syndrome, unspecified left limb; Status post left carpal tunnel release; and Adhesive capsulitis of right shoulder (M75.01).

Examination of the right elbow reveals focal tenderness over the medial and lateral epicondylar region of her right elbow.

On 10/09/2017, the claimant was 4 months post reconstructive surgery. It was noted that he had been doing well. His incision was healed with a good mass of the biceps and good excursion with a range of motion of the elbow.

For the purpose of this assignment, Figure B will be discussed in most detail, referencing to Figure A as the injury and Figure C as the treatment outcome. Documentation is scarce in regards to the initial injury, however it was reportedly sustained during karate practice in Las Vegas. A physician note from Dr. John L. Danielson, M.D, states that he was referred to the Desert Orthopedic Medical Group on September 19, 1973 after being seen in Palm Springs for follow-up care from his injury. On this date, depression and swelling of the fifth knuckle is noted on exam, while the prior x-ray (Figure B), clearly reveals a fracture to the neck of the fifth metacarpal finger of the left hand with the bone visibly pressed inward towards the palm. On the lateral view of the hand, the bone can faintly be seen creating a sideway “v” shape. Of note, an immobilizing device can be seen from just above the metacarpophalangeal joint (MCP) down to mid

The primary cause of a fracture is trauma from car accidents, sports injuries and falls. The trauma may be a direct blow to the bone or an indirect force from muscle contractions or pulling on the bone. Other factors that may contribute to fractures include: vigorous exercise, malnutrition, genetic factors, and osteoporosis. The most common cause of a distal radius fracture is falling onto an outstretched arm (Ignatavicius & Workman, 2013). “Wrist fractures of the distal radius are common and may present special problems for the surgeon and therapist. There are several categories of distal radius fractures, but the Colles fracture of the distal radius is the most common injury to the wrist and may result in limitations in wrist flexion and extension, as well as forearm pronation and supination, resulting from the involvement of the distal radioulnar joint” (Early, p.613).

O: Right Shoulder: no edema; no discoloration; no warmth present to her right shoulder; full ROM; no neurovascular impairment; radial and ulna pulse +3; no impairment of the wrist joint or finger joints; all sensation intact; grip strength +5.

O: Right Hand: No redness, no swelling, pain with palpation of right ulna border, tight muscle, and dimpling of muscle around the area. Intact NVS, increased in pain to the area with grip test,