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.


NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

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4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


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