case 1
female pt. ,35 years old , married , live in 'somewhere in countryside of alex',admitted on 22/o5/11
c/o - low back pain since 2 months
- also tingling in the leg which is more on the left side
-sciatica
present hx
- condition started 2 months ago as she try to lift heavy object.
the pain was like' toothache'
it was progressing,radiating to the thigh and leg.
aggravated by bending forward and backward and relief a little as she standing straight and have bed rest in flex position.
she also claimed that when she woke up in the morning from sleep she can't walk on her foot as she felt severe pain
past hx
she used to work as labourer and have to lift cement weight 50kg on her back and shoulder everyday.
she onced felt pain on her lower back.
see doctor and the doc prescribed her NSAIDS and the pain subsided(wat an ignorance doc,knp x suh wt at least Xray?)
after long time she felt pain on her stomach
no dm,no ht,no bilharziasis,no virus c....
no special habit
no similar condition in her family member
examnitaion done
result -
can't sit and stand comfortably
breast not on the same level
flattening of cervical lordosis
lateral deviation of lumbar vertebrae to the left
pelvis not on the same level
can't walk on tip toe or on the heel
rasing leg test - the angle of extension diminished
x ray - disc space widen
mri - 'black disc' or disc prolapse
moral of the story:
nerve root compression - present with refer pain..
so kna ingt dermatomes of LL ok?
case 2
male,23 years old,single
c/o pain in knee joint
hx - chronic sinusitis and take NSAIDs
x-ray- avascular necrosis head of femur(d.t chronic intake of NSAIDs)
--> pt come with knee pain or lumbar region pain - should alway suspect sumthing's wrong with hip joint
case 3
male child, 6 years old
pain on upper tibia
give history of fever and fall
--> always suspect acute osteomyelitis in child if pt give those type of complaints till proved otherwise
ALERT!..SAY NO TO IGNORANCE!
