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
The patient, 43 year old, used to be very physically active and carry a large amount of equipment on him.
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.
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.
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.
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.
A 40 year old healthy patient sustained a traumatic dislocation of his shoulder combined with a fracture of the greater tuberosity.
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.
65-year-old female that suffers from pain in the left knee underwent examinations that showed femoral-tibial arthrotic manifestations, external degenerative meniscal tear and moderate joint effusion. A diagnosis of external degenerative meniscal tear was established. Further medical tests showed marked degeneration of the meniscal fibrocartilage, diffuse femoral-tibial arthrotic abnormalities, subchondral cysts and edema of the spongious bone, as well as rarefaction of the cartilage matrix, and manifestations of chondropathy.
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.
44-year-old male that sustained a contusion to his left shoulder while falling at his home. Following the fall he suffered severe pain. An ultrasound to the shoulder was interpreted as showing some changes in the ACJ and peritendinitis of the biceps brachi. The orthopedic surgeon that examined the patient about 2 weeks post injury had the impression of tendinopathy and requested an MRI that had indicated changes in signals in the ACJ and superior impingement of the supraspinatus and peritendinitis of the biceps. On the basis of these findings an arthroscopy was suggested.
A 50 years old male with generalized ligamentous laxity and long history of distortions (Sprains) of the ankles. On the right ankle the incidence and severity of the sprains had increased significantly in recent months. On MRI imaging of both ankles: in the right ankle the lateral stabilizing ligaments are damaged and incongruent. On the left ankle the picture is similar with an old fracture of the tip of the medial malleolus which is not united, but not significantly displaced. Right ankle instability was diagnosed and “Brodstrum“ type operation on right ankle has been suggested.
73-year-old male with a diagnosis of Parkinson's disease (PD) since 2001. The cause for this consultation is a problem in the left foot that appeared in 2005 and has worsened since. The diagnosis was "a serious pronated flat foot transverse to the left” causing pain radiating up to the thigh and hip and causing recurrent falls with serious injury.
10 months old, female. After normal birth (at the 40th week of pregnancy) and neonatal period, started to suffer from gastroesophageal reflux and recurrent respiratory infections, at times with broncospasm. In addition, psychomotor retardation was found and the young patient was assessed by a neurologist. The tests run (EMG and genetics for SMA) pointed to the diagnosis of Spinal Amyotrophy.
After hospitalization due to catarrhal bronchitis, the patient was discharged in good general conditions with recomendations for respiratory physiotherapy and neurological rehabilitation.
47-year-old female with a diagnosis of Multiple Sclerosis ,who suffers from progressive tetraparesis, more pronounced in the lower extremities. Her treatment included mitoxantrone and Interferon-beta treatment, both were discontinued because of side effects. Her movement difficulties, due to the left lower limb rigidity, are increasing progressively.
66-year-old female underwent a left suboccipital craniotomy for resection of a tentorial meningioma. The postoperative course has been difficult, marked by deterioration associated with posterior temporal and cerebellar edema and hemorrhage. First she seems to be in good general conditions showing only a slight strength deficiency in the left upper limb, but about a month after the surgery she started showing asthenia and melena, and esophageal gastroduodenoscopy revealed a sclerosis of active arterial bleeding from duodenal ulcer.
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.
