Jan 25 • CASE STUDY CORNER
FIRST COMPLEX CASE STUDY OF THE YEAR 🚨
Let me see what your clinical reasoning is like!
SHx/
54 YO F presented with intermittent bilateral “pins & needles” in her wrists/hands ; 3rd digit numbness +
Chronicity - 2 months
Sleep affected/unaffected - Yes ; ++night in L) 3rd digit
Aggs - Nil movements ; transient symptoms ; worse at night
Occupation - Step teacher, and special needles teacher
Scans/radiology - Client visited GP for scans. Client went and got CT scan for neck and ultrasound wrists.
CT scan Cx result -
Moderate left foraminal narrowing C6/7 with potential irritation left C7 nerve
Ultrasound wrists result -
- Thickening of median nerves within carpal tunnels bilaterally
- Right volar wrist ganglion
Client visited a Physio who specializes in carpal tunnel & was advised to use splinting at night for the next 4-6 weeks & to avoid loaded wrist extension and to use anti inflammatory gel if pain is excessive.
No rehab was prescribed
No manual therapy was administered
Physio recommended nerve conduction study if symptoms did not settle
Here are my questions to you -
A) What would your assessment & differential diagnosis be?
B) What would your treatment be based on the above?
C) How would your treatment plan shape your rebooking strategy?
READY. SET. GO 🚀🚀🚀🚀🚀🚀🚀
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FIRST COMPLEX CASE STUDY OF THE YEAR 🚨
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