35 years old male. 3 years ago an episode of lumbar pain. After an X-ray test and lumbar spine MNR a disc herniation was diagnosed. Later on, disorders showed up sporadically, and 15 days ago, as a result of backache recurrence, the patient decided to carry out diagnostic deepening performing a new lumbosacral magnetic resonance and an electromyographic examination.
73-year-old female with history of backache and diagnosis of Adult Scoliosis, fell down getting a back trauma at the level of the left hip and inferior limb. After severe symptomatic worsening X-ray examination was performed. The findings were: asymmetric pelvis, bilateral coxarthrosis, coarse arthrosic and osteophytosic manifestations, discopathies and disc arthrosis. The prescribed therapy included Piroxicam, Tioside, Depalgos, and low-molecular-weight-heparin therapy that was later replaced by NSAIDs by injection
35-year-old female experienced an episode of lower back pain. Her doctor prescribed injections with Orudis, followed by further treatment with Voltaren. The treatment resulted in a simple remission of pain, that then re-appear at the same intensity as initially. The doctor established a new treatment that consisted of Indoxen and Bentelan. The patient experienced a remission of symptoms until even more intense lumbar pain returned spreading to the left leg. She recieved Voltaren, Muscoril, and Indoxen. Lumbar-sacral NMR showed disc central protrusion.
75-year-old male with multiple complaints related to both his lumbar and cervical spine. He complains of low back pain, cramping and numbness in his thigh muscles, radiating left leg pain to his toes, as well as unsteady gait. He experiences numbness in his shoulders, arms and hands that gets worse over the day. He had a C4-5 fusion and a lumbar procedure at L4-5. The cervical MTI showed degenerative disease worse at C6-7 where there is moderate central and foraminal stenosis.
The patient experienced an episode of lower back pain while carrying home shopping bags. Her family doctor diagnosed a “left lumbosciatic pain” and prescribed injections with vials of Orudis and Voltaren. The treatment resulted in temporary remission, therefore the patient started a new treatment regiment of Indoxen and Bentelan + acupuncture treatment which was partially beneficial.
27-year-old female with a diagnosis of suspected fibromyalgia. Her history includes long standing widespread musculo – skeletal pain connected to a feeling of general slight illness, as well as a series of accompanying symptoms: frequent migraines, cervicalgia, stomach disorders, chest pain and tachycardia . Therefore, she has carried out various follow-ups that each time detected a different problem for which the relevant therapy was set out.
70-year-old female with a history of diabetes mellitus began experiencing pain in the legs. In the last few months the pain localized in her inner thighs. It is burning in nature, with sudden intense attacks, and is consistent with neuropathic pain with neuralgic features. The expert suggests possible diagnosis, further investigation and symptomatic treatment. In his opinion, it is likely that the cause of the symptoms is peripheral neuropathy or radiculopathy.
The patient is a 52 year old male, who is suffering from backache and carried out imaging tests of the lumbosacral spine. Plain x-rays showed mild left scoliosis without rotation, sclerosis at the L5S1 facets, marginal osteophytes, and decrease in the height of the L5S1 disc space.
The patient, 43 year old, used to be very physically active and carry a large amount of equipment on him.
25-year-old male had an outbreak of sharp pain in the loin, and afterwards complained of partial sensory anesthesia in his leg. He has been given prescribed treatment that included blockades, magnetotherapy, and ultrasound massage with hydrocortison. He experienced back pain for the first time after lifting a heavy thing, and got a pain relief after taking a pain-killer and applying Finalgon ointment. After few months the pain reoccurred. The patient then got a MRT test and was prescribed Finalgon and Milgamma pills, but developed an allergy towards Milgamma.
75-year-old male with multiple complaints related to both his lumbar and cervical spine. He complains of low back pain, cramping and numbness in his thigh muscles, radiating left leg pain to his toes, as well as unsteady gait. He experiences numbness in his shoulders, arms and hands that gets worse over the day. He had a C4-5 fusion and a lumbar procedure at L4-5. The cervical MTI showed degenerative disease worse at C6-7 where there is moderate central and foraminal stenosis.
39-year-old male experienced in 1994 intense lower back pain after lifting weights, with spontaneous resolution. In 2006, he again experienced lower back pain radiating into both thighs. A lumbar MRI showed degenerative changes and EMG test showed L5 nerve root irritation. His physical examination demonstrated increased reflexes and a concern for cervical stenosis was entertained. Further cervical MRI and lumbar studies showed arthritic changes, and the thoracic MRI showed evidence of spinal cord compression. The surgeon suggested posterior thoracic laminectomy.
54-year-old male that Since the age of 35 years seeks medical help for Lower urinary tract symptoms mainly of irritative nature. Urological, Neurological, Orthopedic & Psychiatric aspects of his symptoms were evaluated. The patient was treated with a variety of drugs with marginal benefit.
25-year-old male suffers from pain in his left knee that shows up after carrying out a limited physical activity. The length and the importance of the pain are proportional to the intensity of the physical activity, the pain is gradual, and is linked to the movement of the knee joint. Knee MRN showed misalignment of the femur and kneecap with the patella, diffuse superficial edema of the kneecap cartilage, and signs of diffuse tendinopathy. In the expert's opinion, the patient suffers from patello-femoral knee pain due to patellar malalignment or patellar maltracking.
A 58 years old male. 4 years ago the patient was hospitalized due to acute thrombosis of the right femoral-iliac axis. The patient was treated succesfully with locoregional intra-arterial fibrinolytic therapy. A follow-up arteriography, revealed sub-occlusion of the common iliac, occlusion of the right superficial femoral artery in Hunter’s canal. PTA + stent of the iliac was carried out with excellent final angiographic result.
43-year-old male suffered of cervical disc herniation, and therefore C5-6 and C6-7 discectomy and fusion were done. About one year later he experienced acute sciatica followed by hot pricking sensation in the arm and neck. MRI showed far lateral bulge of L3-4 on the left and small disc bulge on C4-5, and a larger C5-6 disc herniation. Neurological examination disclosed C6-C7 radiculopathy on the left, minimal weakness of biceps and triceps muscles and reduced biceps reflex. EMG and physical examination were consistent with bilateral radiculopathy, attributed to small disc herniation.
58-year-old female diagnosed with herniated discs at vertebrae L4-L5. MR scans present signs of degeneration in L4-5, mild degenerative scoliosis, secondary narrowing of the canal and of disc space in L5-S1 level, central and left disc herniation at L4-5 level, and swelling of L4 root.
47-year-old male presented with un-provoked portal and mesenteric vein thrombosis that caused persistent radiating pains of upper abdominal quadrants. The examinations found heterozygous factor II mutation, and family survey for the factor II mutation was recommended. The patient started anticoagulant therapy. In the expert's opinion, the main risk factors for portal vein thrombosis are: Prothrombotic disorder, abdominal inflammation, cirrhosis, cancer, abdominal intervention and abdominal infection.
A 37 years old female suffered from multiple traumas caused by road accident with admittance to emergency room- multiple contusions, cervicalgia(due to whiplash) and contusion-laceration injury to left knee. An MRI scan of the knee was performed two months later (MRI findings are attached below) and the patient was examined by a specialist who gave a diagnosis of medial meniscal tear and femur-kneecap pain in the left knee. A broken medial meniscus of the left knee diagnosis should lead to an arthroscopic operation.
Male patient had twist injury of his knee with tear of the ACL and was operated. After the surgery he suffered acute lumbalgia. Twelve days later he was re-admitted for knee effusion and elevated body temperature, and arthrolysis and joint washing were performed. Following the procedure he complained of hypoesthesia of the proximal lower left limb and knee. EMG reveled L4 and S1 root damage, and MRI showed reduced lumbar lordosis and different disc lesions. In case of compression neuropathy (tourniquet), the expert recommends symptomatic only treatment.
7-year-old boy was diagnosed with diffused intra-axial brainstem expansive lesion. The spine MRI scan indicates spread of the patient's tumor down along the spinal cord, in spite of having reduced at the brainstem. The expert agrees that radiation to the spine that the child started receiving is appropriate, and recommends that the child resume chemotherapy to cover the tumor more globally.
45-year-old male who presented with acute onset of flaccid paraparesis more pronounced on the left, sensation of current shocks in both legs and sensory level from the umbilicus downwards. The symptoms have reached their pick within less than a day. On examination the left lower limb was plegic and the right lower limb was partially weak. EMG was interpreted as demyelinating sensorimotor neuropathy. MRI showed hyperintense signals at the dorsal terminal segment of the marrow consistent with myelitis.
