Course Case Study - Tendinopathy 1: Difference between revisions
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== History of Presenting Condition == | <div class="editorbox"> '''Original Editor '''- [[User:User Name|User Name]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div> | ||
== History of Presenting Condition == | |||
Bob is a 45 year old male who has recently started a new job as a manager at the local council offices 10 weeks ago. He has been experiencing a small amount of discomfort on the lateral aspect of his right elbow for some weeks but has noticeably got worse over the past 3 weeks. He has been to his doctor 2 weeks ago who prescribed him a short course of NSAIDs, of which have not helped significantly. He is now starting to develop pain down his forearm and into his hand. | Bob is a 45 year old male who has recently started a new job as a manager at the local council offices 10 weeks ago. He has been experiencing a small amount of discomfort on the lateral aspect of his right elbow for some weeks but has noticeably got worse over the past 3 weeks. He has been to his doctor 2 weeks ago who prescribed him a short course of NSAIDs, of which have not helped significantly. He is now starting to develop pain down his forearm and into his hand. | ||
== Presenting Condition == | == Presenting Condition == | ||
He is experiencing pain on the lateral aspect of his right elbow which is now affecting his activities of daily living. | He is experiencing pain on the lateral aspect of his right elbow which is now affecting his activities of daily living. | ||
| Line 9: | Line 10: | ||
Aggravating factors – playing his guitar, typing on the keyboard at work, painting, using a screwdriver and rock climbing. | Aggravating factors – playing his guitar, typing on the keyboard at work, painting, using a screwdriver and rock climbing. | ||
Easing factors – rest for less than 30 minutes, Ibuprofen occasionally, cold pack. | Easing factors – rest for less than 30 minutes, Ibuprofen occasionally, cold pack. | ||
24 hour pattern pain – | 24 hour pattern pain – | ||
*Morning - increased pain with stiffness 1st thing lasts for about an hour 5/10 VAS | *Morning - increased pain with stiffness 1st thing lasts for about an hour 5/10 VAS | ||
*Daytime – Pain eases with gentle movement in the morning but by mid-afternoon 8/10 VAS struggles to work in the afternoon | *Daytime – Pain eases with gentle movement in the morning but by mid-afternoon 8/10 VAS struggles to work in the afternoon | ||
*Evening – Dull ache late evening with intermittent sharp pain related to activity | *Evening – Dull ache late evening with intermittent sharp pain related to activity | ||
== PMH == | == PMH == | ||
Mild OA knee bilaterally | Mild OA knee bilaterally | ||
Appendectomy age 17 | Appendectomy age 17 | ||
ORIF left wrist fracture 5 years ago | ORIF left wrist fracture 5 years ago | ||
== Social History == | == Social History == | ||
He is right hand dominant, works full time as a manager and the majority of time onto the computer sending emails and answering phone calls. | He is right hand dominant, works full time as a manager and the majority of time onto the computer sending emails and answering phone calls. | ||
In his spare time he goes indoor rock climbing, plays the guitar and has been doing lots of DIY around the home including sanding and painting woodwork and walls. | In his spare time he goes indoor rock climbing, plays the guitar and has been doing lots of DIY around the home including sanding and painting woodwork and walls. | ||
Lives with his wife and 2 children (8 and 13 years old) | Lives with his wife and 2 children (8 and 13 years old) | ||
== Drug History == | == Drug History == | ||
Ibuprofen - 200mg every 4-6 hours | Ibuprofen - 200mg every 4-6 hours<br> | ||
== Objective Summary == | |||
Bob sits with a slightly slumped poking chin posture, he has possibly a small amount of swelling around the lateral aspect of his right elbow. | |||
{| width="400" border="1" align="center" cellpadding="1" cellspacing="1" | |||
|- | |||
| | |||
| Active ROM | |||
| Passive ROM | |||
| Ressisted ROM | |||
|- | |||
| Cervical | |||
| Full no pain | |||
| Full no pain | |||
| Full no pain | |||
|- | |||
| Shoulder | |||
| Full no pain | |||
| Full no pain | |||
| Full no pain | |||
|- | |||
| Elbow Flex | |||
| Full no pain | |||
| Full no pain | |||
| Full no pian | |||
|- | |||
| Elbow Exten | |||
| Full no pain | |||
| Full no pain | |||
| Full no pain | |||
|- | |||
| Elbow pronation | |||
| 3/4 discomfort | |||
| Full discomfort | |||
| 4/5 oxford, discomfort | |||
|- | |||
| Elbow Supination | |||
| 3/4 discomfort | |||
| Full discomfort | |||
| 4/5 oxford discomfort | |||
|- | |||
| Wrist Flexion | |||
| 1/2 pain | |||
| 3/4 pain<span class="Apple-tab-span" style="white-space:pre"> </span> | |||
| 4/5 discomfort | |||
|- | |||
| Wrist Extension | |||
| 1/2 pain | |||
| 3/4 pain + | |||
| 4/5 pain++ | |||
|- | |||
| Radial Deviation | |||
| Full no pain | |||
| Full no pain | |||
| Full no pain | |||
|- | |||
| Ulna Deviation | |||
| Full no pain | |||
| Full no pain | |||
| Full no pain | |||
|} | |||
<br>Special Tests | |||
[[Cozen’s Test|Cozens]] +ve | |||
[[Mill’s Test|Mills tests]] +ve | |||
Palpation - Pain on lateral aspect of elbow, common extensor origin and generally down into wrist extensor muscles. | |||
[[Category:Case Studies]] | |||
[[Category:Tendinopathy]] | |||
[[Category:Elbow]] | |||
[[Category:Course Pages]] | |||
[[Category:Plus Content]] | |||
Latest revision as of 10:00, 18 August 2022
Original Editor - User Name Top Contributors - Kim Jackson, Michelle Lee, Simisola Ajeyalemi, Admin, George Prudden and Olajumoke Ogunleye
History of Presenting Condition[edit | edit source]
Bob is a 45 year old male who has recently started a new job as a manager at the local council offices 10 weeks ago. He has been experiencing a small amount of discomfort on the lateral aspect of his right elbow for some weeks but has noticeably got worse over the past 3 weeks. He has been to his doctor 2 weeks ago who prescribed him a short course of NSAIDs, of which have not helped significantly. He is now starting to develop pain down his forearm and into his hand.
Presenting Condition[edit | edit source]
He is experiencing pain on the lateral aspect of his right elbow which is now affecting his activities of daily living.
Aggravating factors – playing his guitar, typing on the keyboard at work, painting, using a screwdriver and rock climbing.
Easing factors – rest for less than 30 minutes, Ibuprofen occasionally, cold pack.
24 hour pattern pain –
- Morning - increased pain with stiffness 1st thing lasts for about an hour 5/10 VAS
- Daytime – Pain eases with gentle movement in the morning but by mid-afternoon 8/10 VAS struggles to work in the afternoon
- Evening – Dull ache late evening with intermittent sharp pain related to activity
PMH[edit | edit source]
Mild OA knee bilaterally
Appendectomy age 17
ORIF left wrist fracture 5 years ago
Social History[edit | edit source]
He is right hand dominant, works full time as a manager and the majority of time onto the computer sending emails and answering phone calls.
In his spare time he goes indoor rock climbing, plays the guitar and has been doing lots of DIY around the home including sanding and painting woodwork and walls.
Lives with his wife and 2 children (8 and 13 years old)
Drug History[edit | edit source]
Ibuprofen - 200mg every 4-6 hours
Objective Summary [edit | edit source]
Bob sits with a slightly slumped poking chin posture, he has possibly a small amount of swelling around the lateral aspect of his right elbow.
| Active ROM | Passive ROM | Ressisted ROM | |
| Cervical | Full no pain | Full no pain | Full no pain |
| Shoulder | Full no pain | Full no pain | Full no pain |
| Elbow Flex | Full no pain | Full no pain | Full no pian |
| Elbow Exten | Full no pain | Full no pain | Full no pain |
| Elbow pronation | 3/4 discomfort | Full discomfort | 4/5 oxford, discomfort |
| Elbow Supination | 3/4 discomfort | Full discomfort | 4/5 oxford discomfort |
| Wrist Flexion | 1/2 pain | 3/4 pain | 4/5 discomfort |
| Wrist Extension | 1/2 pain | 3/4 pain + | 4/5 pain++ |
| Radial Deviation | Full no pain | Full no pain | Full no pain |
| Ulna Deviation | Full no pain | Full no pain | Full no pain |
Special Tests
Cozens +ve
Mills tests +ve
Palpation - Pain on lateral aspect of elbow, common extensor origin and generally down into wrist extensor muscles.
