Recent content by MD87

Yes. And then finally the patient will know what it is like to be truly pain free.

Guy has non-specific LBP. Pain in all directions. Pain with flexion - RFA won’t work. Surgery won’t work. PT. Tylenol. Lumbar brace. Maybe celebrex depending on comorbidities. The worst thing that could happen is placebo response from pars injection (just like the placebo he had from the MBBs)...

No issue other than that the effort/$ ratio is horrendous given the cleaning/prep time.

Lumbar corset for lumbar fracture, TLSO sleeq for higher fractures. Told to wear only for comfort and not to get it if uncomfortable.

Try to find an ACGME fellowship that is most similar to a NASS fellowship. That’s what I did. Could not be happier with my training. Having said that, for my current job, half the guys I work with (at least) didn’t get the “piece of paper.” So, assuming I stay at my current gig, it makes no...

I don’t bring them back into the office either. But if I did, pretty sure could be a 99214.

Incidence of transitional anatomy in the literature is 5-15%. Anecdotally, I think closer to 15%. I always document in my note whether there is presence of lumbarizarion/sacralization or tiny ribs. Saves you a headache day of the injection. The more you look the more you’ll see it!

FYI that is a very odd link. It says c4/5 but it’s in the c5/6 joint. Also, it says “epidural” but contrast is only in the joint. https://pubmed.ncbi.nlm.nih.gov/35944084/ Props to Rolotomassi for introducing this technique on the forum.

Problem is my cervical epidurals also help knee pain.

Cervical RF is a challenging procedure. There are lots of threads on here from experienced docs asking for new tips and tricks. Even a lumbar TFESI can be challenging in some cases. Anyone on here who says they were as good at a lumbar TFESI on day 1 as an attending compared to day 2000 is...

What region are you in?

Lol. Definitely # 1, and an overly cautious surgeon who didn’t want it to turn into #2

Soooooo I saw the patient. Definitely NOT CRPS. Ha! Thanks for everyone’s help, though.

I am seeing the patient this afternoon. Patient was diagnosed with presumed CRPS. By the hand surgeon who noted a significant change between the initial consult and the day of surgery. He is about 50 years old and he’s a very smart guy, lots of experience. It was not a typical “delayed swelling”...

Patient with hand injury requiring surgery. On initial eval, exam/appearance of hand was straightforward. On day of surgery, hand had RSD-type picture. Surgery delayed. Has had symptoms for 72 hours. I honestly have never seen someone this early on. Is SGB indicated this early on? High dose...