Case Study: Suzanne Subluxator
Sheldon, Penny, Leonard
KAAP309-17S
March 15, 2017
1. New Terms
FOOSH: fall onto outstretched hand
Iliotibial band syndrome: A condition in which…(7). See Figure 1.
Piriformis syndrome: A condition in which…(2).
Tests:
Speed’s: A test for …
Yergason’s: A test for problems with the long head of biceps tendon in the bicipital grove. The elbow is flexed to 90 and forearm held in a pronated position by the examiner. The subject supinates against resistance. The test is positive if there is pain in the anterior deltoid region. (1) See Figure 2.
2. Significance of patient’s subjective report and personal medical history
The subject’s lack of exercise now and in the past is significant, because it prevented the subject from developing strong muscles and bones. This makes her more susceptible to a sprains and fractures. Her gender is a risk factor for osteoporosis (6). [Give reasons why the items in the subjective report and history are or are not significant.]
3. Family medical history significance
Her paternal grandfather’s death from lung cancer at age 62 is not related to the subject’s likelihood of having musculoskeletal problems or symptoms. Her mother’s treatment for osteoporosis at age 50 is significant . Osteoporosis, which causes thinning and weakening of the bones, has a strong hereditary component (6). Since the subject’s mother is being treated for osteoporosis at a relatively young age, there is a good chance that the subject has a genetic predisposition toward osteoporosis and correspondingly weak bones. [Explain why family history items are or are not significant.]
4. BMI
The subject’s BMI is 100 metric tons/hectare.
4.a. Role, if any, of BMI in patient’s condition
The BMI of 100 metric tons/hectare is underweight. [Explain what this might mean for Suzanne and her complaints, and if it has any relevance to her diagnosis and/or treatment.]
5. Significant findings from physical exam
Suzanne’s PROM and MMT results are notable for … [State whether test results are normal or abnormal. If the latter, state which results are abnormal and what those abnormalities suggest. You may want to use a table showing normal ranges along with the actual test results, highlighting the abnormal results, or do it some other way.]
The other tests are notable for … [Pay special attention to test results that support or refute the original diagnoses, and test results that suggest an alternate diagnosis. Don’t forget the information in the “Comments” section.]
6. Assessment and diagnosis
I disagree with the diagnosis of X, because the Y test results were normal. I agree with the diagnosis of Z because …
I diagnose a torn tensor tympani muscle, because …
7. Treatment Plan
I recommend …
I also recommend… [You might suggest drugs, diagnostic and/or therapeutic procedures, surgery, imaging studies, exercise programs, PT, alternative medicine. You could recommend a test or procedure, and if the result is A, do this; if the result is B, do that…]
References
1. Athletic Training Supersite [Online]. http://www.mhhe.com/hper/physed/athletictraining/illustrations/ch22/22-17a.jpg [2015-09-28].
2. Ausubel FM, Brent R, Kingston RE, Moore DD, Seidman JG, Smith JA, Struhl K. Current Protocols in Molecular Biology. New York: Wiley, 1995.
3. Cluett J. (Dec. 19, 2014). Piriformis syndrome [Online]. About.com. http://orthopedics.about.com/cs/sportsmedicine/a/itbs.htm [2015-09-28].
4. Dudoit S, Yang YH, Callow MJ, Speed TJ. (Sept. 3, 2000). Statistical methods for identifying differentially expressed genes in replicated cDNA microarray experiments. [Online]. Dept. of Statistics, Univ. of California at Berkeley. http://www.stat.berkeley.edu/users/terry/zarray/Html/matt.html [2015-09-28].
5. Friedman N, Linial M, Nachman I, Pe’er D. Using Bayesian networks to analyze expression data [Online]. Stanford University. http://robotics.stanford.edu/people/nir/Abstracts/FLNP1Full.html [2015-09-28].
6. Greenspan, SL. Osteoporosis. In: Cecil Essentials of Medicine, 6th ed., edited by Andreoli TE et al. Philadelphia: Saunders, 2004.
7. Martinez JM, Lorenzo CT. (Sept. 4, 2014). Physical Medicine and Rehabilitation for Iliotibial Band Syndrome [Online]. http://emedicine.medscape.com/article/307850 [2015-09-28].
8. Mayo Clinic Staff. (June 12 2015). Baker's Cyst [Online]. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/bakers-cyst/basics/definition/con-20023332 [2015-09-28].
9. Pollock DM. Endothelin receptor subtypes and tissue distribution. In: Endothelin Molecular Biology, Physiology, and Pathology, edited by Highsmith RF. Totowa, NJ: Humana, 1998.
10. Villalobos AR, Parmelee JT, Renfro JL. Choline uptake across the ventricular membrane of neonate rat choroid plexus. Am J Physiol Cell Physiol 276: C1288-C1296, 1999.
Reference 1 is for an image found online. Refs 2, 6, 9 are articles or chapters in books. References 3, 4, 5, 7, 8 are online articles. Reference 10 is a journal article.
Keys to Success
See the specific instructions for the case study at labinfo.html.