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- W4387061566 abstract "HISTORY: An 18-year-old female college softball shortstop presented with roughly 7 months of RUE pain, numbness & tingling. She initially noticed paresthesia & loss of sensation while shooting a basketball, travelling down her right shoulder to the dorsal aspect of her hand, specifically her middle & ring finger & her forearm. Prior to that she had engaged in a maximal lift training session resulting in stiffness in her neck. Right-sided neck pain & UE weakness then progressed without known provocation. She was seen by her chiropractor for cervical HVLA & initial x-rays were reportedly negative. HVLA manipulations did not provide relief. Symptoms progressed to a point where she was unable to throw an overhand softball due to pain. No PMH, meds, prior cervical injury. PHYSICAL EXAMINATION: C-Spine:Inspection: No deformitiesPalpation: R C4-C5 transverse process tenderness to palpationROM: Flexion is chin to chest, extension to -15 deg with reproduction of symptoms down her RUE and cervical spine discomfort. Rotation to 90 deg B/L and leftward rotation reproduces symptoms in the RUE. Side bending to 30 deg B/L without symptoms. FROM in shoulders B/L.Strength: RTC 5/5 B/L.Spurling: Reproduces symptoms on the R with L rotationSpecial: -Adson, - RoosSensation: Median, radial, ulnar dermatomes intact B/LDTR: 1+ at triceps, biceps, brachioradialis B/LPulses: +2 radial/ulnar DIFFERENTIAL DIAGNOSIS: 1.Cervical radiculopathy due to a disc herniation2.Cervical spondylosis3.Thoracic outlet syndrome4.Radial nerve entrapment TEST AND RESULTS: C-spine XR: Straightening of normal cervical lordosis. No fractures. Disc spaces/alignment normal. MRI Cervical WO Contrast: C5-C6: Right paracentral HNP measuring 8 x 12 mm in anterior–posterior and 9.5 mm craniocaudal dimensions. Severe right lateral recess and proximal neural foraminal stenosis. Central canal measuring 7.3 mm. Deformation of the cervical cord and thecal sac. C6-C7: Left paracentral annular tear and small superimposed HNP. No stenosis. C2-C3, C3-C4, C4-C5, C7 and T1: Normal examination. FINAL WORKING DIAGNOSIS: C5-C6 cervical herniated nucleus pulposus with radiculopathy TREATMENT AND OUTCOME: 1.No sports participation. May participate in cross training as tolerated2.PT for cervical ROM and strength training3.Spine surgery consultation" @default.
- W4387061566 created "2023-09-27" @default.
- W4387061566 creator A5091150794 @default.
- W4387061566 date "2023-09-01" @default.
- W4387061566 modified "2023-10-14" @default.
- W4387061566 title "Neck Injury-Softball" @default.
- W4387061566 doi "https://doi.org/10.1249/01.mss.0000986168.55998.cd" @default.
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