54 Year Old Tennis Player With Crippling Right Thigh Pain

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54 Year Old Tennis Player With Crippling Right Thigh Pain - Page #3

Lab Studies: ESR 10 CRP 49 CBC normal CK normal Lytes normal Ca normal Mg normal Other Studies: Knee XRAYs: Severe patellofemoral arthritis Case Photo #1 MRI lumbar spine: Right sided disc protrusion affected right L3 nerve Case Photo #2 MRI entire spine: Myelomalacia MRI head: juxta ventricular T2 hyperintense lessons Consultations: Neuro consult: Felt her pain was due to the nerve impingement and recommend spine surgery consult. Spine consult: ? whether pain is due to nerve root and confirmed positive babinksi. Trial of diagnostic nerve block at right L3 nerve. They recommended the MRI of the entire spine. Case Photo #3 Neuro consult (again): Given failed nerve root injection and MRI findings of myelomalacia, a more thorough history was obtained and revealed the gait disturbance has been more gradual. The patient also endorsed blurry vision two years prior. They recommended an MRI of the head to rule in MS. Case Photo #4 Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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