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Bi-Lateral Neck/Arm Burning-Clean MRI

Exit forum ID Forum Discussion Bi-Lateral Neck/Arm Burning-Clean MRI

This topic contains 4 replies, has 3 voices, and was last updated by   Jamie Hansen July 1, 2019 at 3:17 pm.

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  • #7502

    Jamie Hansen
    Keymaster

      Hi Everyone,
      I am a stumped with this case and was hoping that maybe I missed something that someone can spot out.

      1st Order HX
      Age: 24 Male
      SX Location: Posterior Neck into Bilateral triceps/medial forearm (medial and lateral aspects), pinky and ring fingers. Occasional bilateral index finger and dorsal aspect of hand.
      SX Qual: P&N/Burning
      SX Intensity: AVG, 7/10,,, worse 10+/10….. pain is never a 0/10 absolute best is 2-3/10
      Provocative: All movements, worse with felxion & rotation, any and all exercise.
      Pallative: Rest, thera-gun, adjustments (all short term)

      2nd order:
      Onset: MVA all re-ended accidents 8/2017, 11/2017, 1/2018.
      -After 11/2017 accident neck pain started along with L and R arm sx (left first) much worse after 1/2018 accident.
      -MRI after 3rd accident, came back clean.
      Occupation- student
      currently seeing Dr Stepien for Lower back issues steaming from 8/2017 MVA

      Exam Findings:
      UCF- 16/25 able to get him to 26/25 but still has sever pressure left arm burning, along with L Levator scap area burning.
      CF 66/60,,, re-exam 66/60 no change in SX same as above
      CTF-80/90 rexam 90/90 with same sx
      ROT L-60/90 R79/90 (still working on these tests last treatment L 76/90, R 77/90 (same SX severe with burning into hands)

      Lateral Flexion: L 30 degrees with burning to hands and R levator scap area (same as CC) R 30 degrees, burning into hands and significant burning into L Levator scap area.

      Shoulder AB 1.5 Fingers bilaterally with burning into LS.

      BC SX were not improving and it has been ~8 months since his last Cervical MRI, he got another one and this again was clean (this was last week).

      Past treatment of L shoulders (performed by): L Infra- mod adhesion created burning into Left dorsum of hand, brachial cords are sub scap mild/moderate, Post JT Capsule -mild/clean.

      I am finding mild/moderate adhesion on L Levator scap, L NR at scalenes,
      Only real sustained relief I have been able to get him was decrease the number of HAs from 4x/wk to once a week/10days.

      Am i missing something here?
      Open to any and all help

      THANK YOU!!

      #7503

      Andrew Wengert
      Participant

        I lived in the auto accident world before ID saved my career and sanity.
        One test we did order in that world was a digital motion X-ray or even just plain flexion extension films with a note to the radiologist to check for ligament instability. Having had 3 MVAs his ligaments likely had some degree of damage which could explain his symptoms.

        #7505

        Jamie Hansen
        Keymaster

          Thank you Andrew for this. I will look into this some more.

          #7507

          Tyler Vorst
          Participant

            Did you look at the images yourself, or only the report. I’ve had radiologist not include disc pathologies in the past on the radiology reports.

            #7508

            Jamie Hansen
            Keymaster

              Tyler,
              We looked at the images our selves, and we have Dr Nina in office has a diplomat in reading images.

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