PCL/14 Feb cases

From IKE

Contents 1 Case 1 2 Case 2 3 Case 3 4 Case 4 5 Case 5

Case 1

35 year old female with shoulder problems

• Differential diagnosis:
  • Frozen shoulder (Adhesive capsulitis)
  • Atrophy of the deltoid
  • Subacromial bursitis
• Investigations:
  • Ultrasound - would rule out tendonitis and bursitis
  • Plain film X-ray

Case 2

Mrs. Smith: 30 year old woman

• Get a proper history:
  • Nature of pain (OPQRST..)
  • Symptoms - vision, gait
  • Social history
• Differential diagnosis:
  • Subarachnoid hemorrhage
  • Migraine
  • Meningitis
  • Encephalitis
  • Tension
  • Psychosis
  • Tumour

• Investigations:
  • Head CT with contrast
  • CBC and electrolytes
  • Toxin screen (?)

• Clinical features of migraines:
  • Classical migraines have auras, and usually follow the pattern: prodrome, aura, headache, postdrome

Case 3

60 year old woman with back pain

• History key features:
  • weight loss, cancer history, improved with flexion

• Differential diagnosis:
  • Spinal metastases

• Investigations:
  • CT scan
  • MRI - better imaging of disc herniation

Case 4

Case 5