|
|
Re: Neck and shoulder pain
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Neck and shoulder pain - January 14, 2005 6:38:00 PM
|
|
|
jbeneciuk
Posts: 112
Joined: November 26, 2004
From: Jacksonville, FL
Status: offline
|
Possibly the first or second rib ?? Looks to be a fracture, especially in the second rib...with a history of trauma, also may have a relation to pt. complaint of neck pain ??
|
|
|
|
|
Re: Neck and shoulder pain - January 14, 2005 6:55:00 PM
|
|
|
Synergy
Posts: 589
Joined: March 11, 2004
From: Forney, TX
Status: offline
|
It almost looks like the shoulder is internally rotated and some scapular abduction and protraction is present. Trough sign maybe?
_____________________________
Chris Adams, PT, MPT
|
|
|
|
|
Re: Neck and shoulder pain - January 15, 2005 2:02:00 AM
|
|
|
bpaton
Posts: 1
Joined: December 11, 2004
Status: offline
|
SC joint involvement and it does look like a fracture in the second rib??
|
|
|
|
|
Re: Neck and shoulder pain - January 15, 2005 4:49:00 AM
|
|
|
jma
Posts: 2322
Joined: August 24, 2000
From: NY
Status: offline
|
Hello,
Fx 2nd rib and an AC separation with an impacted humerus in the glenoid fossa?
JMA
|
|
|
|
|
Re: Neck and shoulder pain - January 15, 2005 5:54:00 AM
|
|
|
chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
|
My money says the second rib is completely normal, and we can't tell whether or not the humerus is impacted from this view, you'd need an axillary view for that.
Army tricked us, the sly cad. He presented one film, and we over-read it. How much do you want to bet that on his other film(s) we'll see what's really wrong?
Opposing views are a basic requirement in a study.
I will go out on a limb though and be honest with you about something. 90% of the pathology on a C-spine study can be seen on the neutral lateral view. Ask DocWagner about that.
_____________________________
Greg Priest, DC, DABCO
|
|
|
|
|
Re: Neck and shoulder pain - January 17, 2005 6:44:00 PM
|
|
|
Synergy
Posts: 589
Joined: March 11, 2004
From: Forney, TX
Status: offline
|
Results Army? :)
_____________________________
Chris Adams, PT, MPT
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 1:25:00 AM
|
|
|
SJBird55
Posts: 2312
Joined: May 10, 2004
From: Michigan
Status: offline
|
LOL Geesh, Chris... have some patience. The guy is off in some country doing whatever military guys do.
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 8:45:00 AM
|
|
|
Synergy
Posts: 589
Joined: March 11, 2004
From: Forney, TX
Status: offline
|
ROFL SJ! I'm just anxious to see the results just like everyone else. It was just an innocent reminder. :)
_____________________________
Chris Adams, PT, MPT
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 9:30:00 AM
|
|
|
Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
Status: offline
|
Hi all, thanks for the patience.
There is a nondisplaced fracture of the left clavicle; midshaft on the inferior aspect. All other structures are within normal limits.
[IMG]http://img.photobucket.com/albums/v85/brennerak/ClavicleFx.jpg[/IMG]
I think this case brings up a several good points which have already been pointed out above. Firstly, you should always ask for a second view because "one view is no view". Secondly, radiographs are easily over-read meaning, to the untrained eye there are many things that could appear pathogical which are actually normal such as the ones mentioned above. This goes to show you how important that a good history and physical examination findings are to the radiologist or any health care provider that attempts to read the films. If you are ever in the situation where you are allowed to order a radiograph, be sure to include a good succinct history and what you would expect from your physical assessment of the patient. Radiologist particularly (at least ours do) like it when you say, "Patient is point tender over the (blank)".
Good job to Pablo who correctly identified the fracture.
Please provide or add any other learning points from this case that you see.
_____________________________
Alex Brenner, PT, MPT, OCS
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 9:36:00 AM
|
|
|
FLOrthoPT
Posts: 85
Joined: October 20, 2003
From: wellington, fl, usa
Status: offline
|
does he get a gold star? Or is it stickers this week?
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 9:37:00 AM
|
|
|
Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
Status: offline
|
I forgot to add that this particular patient was seen in our clinic and did have a Grade II AC separation in addition to his clavicle fracture however, I do not believe that you would be able to see this from his radiograph above. Good thinking Randy.
_____________________________
Alex Brenner, PT, MPT, OCS
|
|
|
|
|
Re: Neck and shoulder pain - January 18, 2005 11:12:00 AM
|
|
|
pablo w
Posts: 88
Joined: November 13, 2002
From: Canberra
Status: offline
|
It was a lucky guess. I wouldn't have seen it if you hadn't said that "the pathology is elsewhere". Having the patient theer usually helps!
Pablo
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.078
|
Printable Version
