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.
Urine drug screen obtained on 04/07/16 showed positive for tramadol and desmethyltramadol.
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.
Symptoms are aggravated by almost any movement, changing positions, lifting,
Patient reports left knee pain history of MVA in 2009 and injured left knee. Patient also reports tooth ache 4/10.
The patient stated that overall the symptoms have decreased. Antalgic gait has improved. The pain is decreased but it increases in the morning. The patient reported pain 3/10-scale level. Rom and Muscle strength remained the same. Swelling has decreased. Tenderness to palpation in the lateral and medial malleolus decreased. Muscle testing plantar flexion remains weak. Dorsiflexion remains weak. Review of Systems revealed joint swelling and loss of bladder/bowel control. Treatment plan included PT
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: 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.
Based on the progress report dated 04/05/16 by Dr. Fieser, the patient complains of pain in the left knee, left ankle and left foot, associated with numbness and tingling in the left leg/foot, as well as weakness in the left leg. He describes the pain as sharp, cutting, throbbing, dull, aching, pressure-like, cramping, shooting and shocking with muscle pain and pins-and-needles sensation.
DOI: 05/13/2012. Patient is a 45-year-old male home attendant who sustained bilateral knees injury when he tripped and fell while he was pushing a client in a wheelchair. As per OMNI, he has undergone right knee surgery on 09/19/2012, 11/01/2013 and 12/10/2014. Patient is status post left knee arthroscopy, partial and lateral meniscectomy, synovectomy and shrinkage of the anterior cruciate ligament (ACL) graft on 12/11/15.
DOI: 12/13/2012. Patient is a 64-year-old male security officer who sustained a work-related injury to the right knee when he missed a step and fell down the stairs. As per Omni, the patient had a right knee meniscus tear. The patient had right knee replacement on 11/19/14. Per QME Dr. Murphy on 08/11/15, the patient has a 20% whole person impairment rating. Future medical care includes 4-6 visits per year for recurrent symptoms, narcotic/nonsteroidal anti-inflammatory drugs (NSAIDS) in addition to gastrointestinal stabilizing medications, pain management specialist monitoring, office visit with an orthopedic surgeon once a year with X-ray, revision surgery in the future and bone scan.
Southern Comfort is often thought of as a whisky, however it is actually a liqueur made from a neutral flavoured spirit with whisky, fruit and spice flavourings.
DOI: 11/15/2010. The patient is a 56-year-old male sales representative who sustained a work-related injury when he tripped on a pallet. As per OMNI, the patient is diagnosed with strain to right knee, right leg and right shoulder and is status post right shoulder diagnostic and operative arthroscopy on 8/10/12.
Patient has no joint pain .No crepitus assessed in both knees. No limitations in range of motion lower extremities verbalized and observed. Patient has no noted problem with gait
Jim Malesckowski remembers the call of two weeks ago as if he just put down the telephone receiver: “I just read your analysis and I want you to get down to Mexico right away,” Jack Ripon, his boss and chief executive officer, had blurted in his ear. “You know we can’t make the plant in Oconomo work anymore, the costs are just too high. So go down there, check out what our operational costs would be if we move, and report back to me in a week.” At that moment, Jim felt as if a shiv had been stuck in his side, just below the rib cage. As president of the Wisconsin Specialty Products Division of Lamprey Inc., he knew quite well the challenge of dealing with high-cost labour in a third-generation, unionized
DOI: 1/25/2008. Patient is a 54-year-old male service technician who sustained a work-related injury when he slipped and fell while installing a tub. The patient is subsequently diagnosed with hemarthrosis of knee or lower leg, hemarthrosis of left knee, lumbar facet arthropathy, bursitis of left shoulder, derangement of medial meniscus due to old tear of left knee, complete rupture of rotator cuff. MRI of knee joint without contrast/-“LT/A” dated 2/17/16 revealed extensive metallic susceptibility artifact which does not allow assessment of the medial femorotibial compartment; there are some degenerative changes of the anterior horn of the lateral meniscus without definite tear; there is low grade chronic partial tearing versus mild mucoid degeneration
related injury to his right shoulder when a bathroom stall door struck him. As per OMNI entry, he is status post right shoulder repair on 09/23/2011 and repeat shoulder surgery on 03/23/2012. The patient was subsequently diagnosed with shoulder impingement syndrome, right. AME dated 1/12/16, future medical provisions states that the left knee will be treated conservatively including anti-inflammatories and perhaps periodic intra-articular cortisone injections. Viscoelestic supplementation is not recommended. It is also stated that it is reasonable to obtain a spinal consultation with someone such as Dr. Jones, Dr. Herron, or Dr. Hutchinson. The prior lumbar MRI scan (6/27/14) demonstrates instability and stenosis, so it is recommended for an
OVERVIEW: This case deals with a manufacturer of women’s shoes that purposely changes styles frequently to take advantage of the flexibility of a small organization. However, decision making in the organization follows such a convoluted pattern that conflict is a given. Work flow needs to be re-examined, and adjusted for efficiency.
10/22/15 Pain management report by Dr. Saidov reported the patient has knee pain. The pain radiates up and down the left leg. The patient describes the pain as burning, aching and dull. The patient reports that the pain is 9/10-scale level on her worst day and 3/10-scale level on her best day. Bending forward, sitting, standing, and walking aggravate the pain. Medications relieve the pain. She has been previously treated with pain medications and PT. The PT was ineffective in controlling the pain. Tramadol was effective. The patient reports no side effects to the medications and states that her functional status improves and her pain is controlled with the medication. The patient is afraid to proceed with the SCS trial secondary to the fear of getting RSD in her spine. The patient admits having sleeping problems. Exam of the left lower extremity revealed decreased temperature in the left knee. There were parasthesias and signs of allodynia in the left leg. Knee stability was decreased on maneuvers and there was severe restricted ROM in all planes. Treatment plan included medication refill for gabapentin, tramadol, clonidine, lidocaine topical and pamelor oral. Follow-up in 1 month.