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Axial back pain, chronic. 60 y/o female. HLA B27 neg. PMH: DM, HTN. No h/o CA. No prior back surgery.
DISH variant? Getting CT ordered. Any idea what is going on here?
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Axial back pain, chronic. 60 y/o female. HLA B27 neg. PMH: DM, HTN. No h/o CA. No prior back surgery.
DISH variant? Getting CT ordered. Any idea what is going on here?
the AP looks like AS, but there are no bridging syndesmophytes on lateral. i think it is just OA, or call it DISH if you like. do an MBB
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Here is the oblique. Will get CT before trying MBB, really to see if this getting into canal and if I have viable targets to acquire.
Love those crooked spines. And the double cross to get leads in position. Left IS left.Her implant healed up.
Under things I’ve never seen before...
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So I have no idea what I am looking at. But I do have the report. Thinking Freddy or Oreos could probably get it.
Guess the underlying problem.
Synovial proliferation from RA compressing artery and vein in popliteal fossa.
View attachment 244798
Per Radiologist, get MRI. Changing referral from Ortho to Vascular. Looks like a popliteal aneurysm at this point. I know a CTA is getting done prior to surgery.
He was braced up for a couple months but did not have surgery. He had multiple other injuries that precluded pretty much anything else. I just see him for some medial branch blocks now and again.ouch
screw above and below with rods in between?
im only seeing blobogram. sorry...
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Referral for new patient. Dropped off mri ahead of visit. Had scs trial elsewhere. MRI when they could not get wires in. Asked me to retrial. No thanks.
Scrotum? Maybe im wrong but i see frontal and lateral skull...dentures/fillings
I believe he’s referring to Dr Lobel’s scrotum, not the patient’s.Scrotum? Maybe im wrong but i see frontal and lateral skull
Done by Neurosurgeon at Emory. I recommended against it. Patient no better.
One lead supraorbital, 1 lead through foramen ovale and an inch into brain.
Gasserian RF trajectory with a 14G Tuohy and leaving a wire is more than I imagine reasonable.
Offered SCS over C2 in the canal for her primary V2 right sided pain.
Did the pain pattern change as that seems like overkill for V2? I'm sure they already offered to drop Nevro percs at C1/C2 for HF10 to the nucleus caudalis to fix all things above the neck.
42 yo M with just under 3 weeks of severe right leg pain. Driving home one day from work (desk job) and right leg started hurting, then couldn't get out of his car. No medical history. Gainfully employed. Wants to get back to work but does not tolerate even minimal ROM of the leg or weight bearing.
IM Toradol, Medrol dose pack, gabapentin, home exercise regimen, follow up in 3 weeks. Will MRI if no better.
I kept thinking I saw fracture but I'm not so sure. That L4-5 disk has seen better days.
The posterior inferior L4 body looks... weird. I’d agree with MRI now too. Definitely enough on physical exam to justify to insurance. Reflexes normal and bowel/bladder normal I assume?42 yo M with just under 3 weeks of severe right leg pain. Driving home one day from work (desk job) and right leg started hurting, then couldn't get out of his car. No medical history. Gainfully employed. Wants to get back to work but does not tolerate even minimal ROM of the leg or weight bearing.
IM Toradol, Medrol dose pack, gabapentin, home exercise regimen, follow up in 3 weeks. Will MRI if no better.
I kept thinking I saw fracture but I'm not so sure. That L4-5 disk has seen better days.
The posterior inferior L4 body looks... weird. I’d agree with MRI now too. Definitely enough on physical exam to justify to insurance. Reflexes normal and bowel/bladder normal I assume?
42 yo M with just under 3 weeks of severe right leg pain. Driving home one day from work (desk job) and right leg started hurting, then couldn't get out of his car. No medical history. Gainfully employed. Wants to get back to work but does not tolerate even minimal ROM of the leg or weight bearing.
IM Toradol, Medrol dose pack, gabapentin, home exercise regimen, follow up in 3 weeks. Will MRI if no better.
I kept thinking I saw fracture but I'm not so sure. That L4-5 disk has seen better days.