Lippincott's Primary Care Orthopaedics by Paul A. Lotke MD, Joseph A. Abboud MD, Jack Ende MD

By Paul A. Lotke MD, Joseph A. Abboud MD, Jack Ende MD

A part of the hugely revered fundamental Care sequence, this 2d variation of Lippincott's basic Care Orthopaedicsprovides kin practitioners, internists, nurse practitioners, surgeon assistants and osteopathic and chiropractic physicians with the reference resource they should optimistically diagnose and deal with the most typical musculoskeletal sufferer accidents obvious in an workplace atmosphere. This full-color, hugely illustrated Read more...


includes age-related differential analysis. This e-book includes ICD nine codes for fast reference. It comprises either fundamental and secondary lab information. Read more...

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Crawford • Nader M. Hebela A 28-year-old female weight lifter presents to clinic with persistent neck and right arm pain for the past 8 weeks. She notes difficulty with certain exercises, especially inclined bench and triceps press. She reports numbness and tingling in her right upper extremity, starting at the shoulder and extending into her fingertips on the right side. She is exhausted from a lack of sleep because the pain keeps waking her up at night. CLINICAL PRESENTATION Herniated disk of the cervical spine refers to the displacement of part of the intervertebral disk material into the spinal cord or nerve roots of the cervical spine.

Cigarette smoking is another factor associated with cervical disk herniation. While some people may be symptomatic only briefly, others may experience prolonged numbness and tingling, usually of the affected upper extremity. , hyperreflexia, clonus, Babinski sign), and loss of strength may also result. Patients may report pain after an acute traumatic event or pain that gradually worsens over a prolonged period of time. They may describe the pain as sharp, burning, or electric shock-like. Associated numbness and tingling may be present.

2 Depending on the extent of weakness, nonsurgical management may be considered for patients with 4 to 4+ out of 5 muscle strength, especially if it does not interfere with activities of daily living. In a patient whose primary means of employment is manual labor, 4/5 strength may be a significant barrier to work when compared with a similar patient whose primary job involves little physical activity. 3,4 Direct decompression of the spinal cord, which helps to decrease the mechanical pressure and restore normal vascular flow, is superior to nonsurgical management.

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