a case study ...

[chef]

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pt: 24 yr old male, otherwise in good health
cc: pain in right hand joints, esp interphalengeal joints in 4 fingers (not hallucis) while typing/using the mouse. no pain when writing or other hand usage. pain onset immediately after starting to use the mouse

hx: pt is a heavy computer user (5+ hrs/day), and 6 mos ago realized that after computer use his hand joints would hurt, but after a while pain subsided. pt didnt stop using the computer, and now the pain starts immediately after starting to use the computer.

cbc & other blood tests for ab's, xray, pe: all nl, no signs of arthritis or degeneration, very slight inflammation

pt has taken naproxen, pain didnt' go away


what do u think is going on?

 

[Andrew_Doan]

Originally posted by chef
pt: 24 yr old male, otherwise in good health
cc: pain in right hand joints, esp interphalengeal joints in 4 fingers (not hallucis) while typing/using the mouse. no pain when writing or other hand usage. pain onset immediately after starting to use the mouse

hx: pt is a heavy computer user (5+ hrs/day), and 6 mos ago realized that after computer use his hand joints would hurt, but after a while pain subsided. pt didnt stop using the computer, and now the pain starts immediately after starting to use the computer.

cbc & other blood tests for ab's, xray, pe: all nl, no signs of arthritis or degeneration, very slight inflammation

pt has taken naproxen, pain didnt' go away


what do u think is going on?

I'm on call tonight, and passing time until my patient arrives... I'll put in my 2 cents while I'm up.

Perhaps this patient has an atypical presentation of repetitive strain syndrome?

Patients who perform repetitive movements, e.g. typists, may feel pain anywhere from finger tip to shoulder to neck.

http://hcd2.bupa.co.uk/fact_sheets/mosby_factsheets/Repetitive_strain_syndrome.html