Article Type
Changed
Mon, 07/09/2018 - 10:49
Display Headline
His Old Pain Is Back

ANSWER

The radiograph demonstrates a fracture within the femoral neck. These types of fractures, which are slightly angulated and located at the base of the neck, are typically referred to as basicervical femur fractures

Prompt orthopedic surgery consultation was obtained, and the patient underwent an open reduction and internal fixation of his fracture.

Article PDF
Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon and is a clinical instructor at the Mercer University School of Medicine, Macon.

Issue
Clinician Reviews - 28(3)
Publications
Topics
Page Number
17,43
Sections
Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon and is a clinical instructor at the Mercer University School of Medicine, Macon.

Author and Disclosure Information

Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon and is a clinical instructor at the Mercer University School of Medicine, Macon.

Article PDF
Article PDF

ANSWER

The radiograph demonstrates a fracture within the femoral neck. These types of fractures, which are slightly angulated and located at the base of the neck, are typically referred to as basicervical femur fractures

Prompt orthopedic surgery consultation was obtained, and the patient underwent an open reduction and internal fixation of his fracture.

ANSWER

The radiograph demonstrates a fracture within the femoral neck. These types of fractures, which are slightly angulated and located at the base of the neck, are typically referred to as basicervical femur fractures

Prompt orthopedic surgery consultation was obtained, and the patient underwent an open reduction and internal fixation of his fracture.

Issue
Clinician Reviews - 28(3)
Issue
Clinician Reviews - 28(3)
Page Number
17,43
Page Number
17,43
Publications
Publications
Topics
Article Type
Display Headline
His Old Pain Is Back
Display Headline
His Old Pain Is Back
Sections
Questionnaire Body

You are called in for a neurosurgical consult of a 60-year-old man who underwent a lumbar decompression approximately 18 months ago. For the past several weeks, he has been experiencing worsening back pain that radiates down his left leg; at times, he has to use his cane and walker. The patient denies any acute injury or trauma preceding the pain; however, last night he slipped and fell in his bedroom, which made it much worse.

Medical history is significant for hypertension and hyperlipidemia. The patient responded well to his previous back surgery. The emergency department clinician is concerned that his symptoms may be caused by a new lumbar stenosis at an adjacent level.

On exam, you note a mildly obese male who appears uncomfortable but is in no obvious distress. His vital signs are stable. He has some tenderness within his left hip. Distally, his strength is good, and there is no evidence of neurovascular compromise. Internal and external rotation causes some discomfort.

A portable pelvic radiograph is obtained (shown). What is your impression?

Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Article PDF Media