--- Chris Murphy <[log in to unmask]> wrote:
> My first reaction to your question was that we
> needed more information. My
> guess when you write that R sf and R rot relieves is
> actually a typing error
> which would suggest that, using the idea of
> increasing or decresing the
> intervertebral foramen or thoracic outlet, he does
> not like closing down and
> this could be due to a number of factors eg mild
> nerve root compression,
> thoracic outlet syndrome, stenosis.
*Checked some stuff out today, first R sf and R rot
relieve pain on left side. Add flexion as well.
> My initial questions were.
> 1. What is his history, is it insidious onset or
> acute in origin
*MVA- Hit on L side. Has had symptoms for the last 6
> 2. What is is job and what past times does he enjoy
> 3. Resting posture ?? including night positions and
* Can sleep soundly as long as head is R sf.
> 4. Are his movements symmetrical
*No limitation in movt.
> 5. Does he have any neuro signs, if not have you
> cleared these any way
> 6. What is the effect of combined movements,
> especially in provocative
*R sf/rot relieves, L sf/rot increases
> 7. Does offloading the shoulder girdle in
> provocative position change his
> symptoms at all
> 8. What are your passive movements like and are
> there any significant
> palpatory findings.
* No palpatory findings, all is normal
*I am thinking it is some kind of stenosis, just don't
know why it would be occurring after an MVA. I will
look into his past x-rays.
> Look forward to hearing more
> Chris Murphy
> ----- Original Message -----
> From: "nabil keshavjee" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Friday, October 12, 2001 2:51 AM
> Subject: Neck pain with referral.
> > I'm kinda stuck with one of my patients. Any help
> > would be greatly appreciated.
> > Subjectively, main complaint is radiating pain
> > to left hand. Mainly happens when he gets into
> > car. Eases as the drive continues. Also occurs
> > sporadically during the day.
> > Objectively(I'll keep it short), right sideflexion
> > right rotation relieve. Flex, ext, R sf, and R
> > increase the pain. Traction in neutral increases
> > pain, traction in 20 degrees flexion decreases.
> > Negative Adsons.
> > Let me know if you need to know more. Getting
> late so
> > I'm half brain dead.
> > Nabil K,
> > __________________________________________________
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