By Lonnie Mercier MD
This article equips you with simply the correct amount of knowledge to make extra convinced diagnoses, deal with the stipulations offered by way of your sufferers, and ascertain while to refer them for extra really good therapy. completely revised and up-to-date, it publications you thru the elemental strategies, diagnostic tactics, and therapy ideas which could assist you enhance your sufferers' point of functionality and decrease their pain.Patient educating publications for greater than 35 problems - together with back soreness, carpal tunnel syndrome, and osteoporosis - assist you support sufferers of their recovery.Comprehensive pharmacology info - together with instructions on utilization, contraindications, and interactions - allows you to observe the simplest sufferer remedy approaches.A bonus CD-ROM permits you to with ease entry all the illustrations and sufferer instructing courses from the book.Nearly 350 illustrations - approximately a hundred new to this version - simply clarify key innovations.
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Extra resources for Practical Orthopedics, 6th Edition
Example text
48 Chapter 4 FIG. 4-6. Bilateral cervical ribs (arrows). one of the various maneuvers. They are required if the initial findings suggest venous or arterial compromise. in the radial pulse or reproduction of symptoms is noted. COSTOCLAVICULAR SYNDROME HYPERABDUCTION SYNDROME The space between the clavicle and the first rib may be narrowed by downward and backward pressure on the shoulders for a prolonged period of time. Abnormalities of the clavicle, such as malunion or nonunion after fracture, may contribute to the narrowing.
In most cases, the diagnosis is clear without further testing. Neck, interscapular, and/or arm pain that is aggravated by neck motion is typical. Eventually, however, the following studies may be needed: 1. Plain roentgenograms are usually performed first. Anteroposterior and lateral views are sufficient. They are usually normal in soft disc rupture. With chronic degenerative 34 Chapter 3 Table 3-1 Clinical Features of Common Cervical Disc Syndromes Disc C4–5 (C5 root) C5–6 (C6 root) C6–7 (C7 root) Pain Base of neck, shoulder, anterolateral aspect of arm Numbness in deltoid region Neck, shoulder, medial border of scapula, lateral aspect of arm, dorsum of forearm Neck, shoulder, medial border of scapula, lateral aspect of arm, dorsum of forearm Sensory Change Motor Weakness, Atrophy Reflex Change Deltoid, biceps Biceps Dorsolateral aspect of thumb and index finger Biceps, extensor pollicis longus Biceps, brachioradialis Index, middle fingers, dorsum of hand Triceps Triceps disc disease, however, there is loss of the height of the disc space with anterior and posterior osteophyte formation.
Nerve conduction studies help rule out peripheral nerve disorders. 5. Discography is controversial. It is also occasionally performed in the evaluation of cervical disc disease, but the diagnosis can usually be well established on the basis of the history, physical examination, and plain films alone. 6. Thermography is mentioned only for completeness. Its validity is uncertain, and it is not commonly used. NOTE: Roentgenographic studies are not always conclusive. False-negative and false-positive results are fairly common.