The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Nov 2009
Case ReportsOsteopathic manipulative treatment in the management of notalgia paresthetica.
Notalgia paresthetica is a chronic sensory neuropathy characterized by pruritus of the upper to middle back, typically below the left shoulder blade. Symptoms may include pain, hyperesthesia, paresthesia, and hyperpigmentation of the affected area. ⋯ After treatment, the patient reported immediate improvement of symptoms. A discussion of this condition based on previously published literature is also provided.
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J Am Osteopath Assoc · Aug 2009
Review Case ReportsExpanding the differential of shoulder pain: Parsonage-Turner syndrome.
A 44-year-old man was in his car when it was rear-ended in a minor motor vehicle collision, during which his right forearm contacted the steering wheel. Shortly thereafter, pain in his right shoulder developed, but initial work-up was unremarkable. His pain progressed to shoulder girdle weakness over several months and did not improve after 2.5 years. ⋯ Repeated electrodiagnostic studies revealed denervation limited to the serratus anterior and right deltoid muscles without evidence of cervical radiculopathy. He was diagnosed with Parsonage-Turner syndrome, which is a neurologic condition characterized by acute onset of shoulder and arm pain followed by weakness and sensory disturbance. The authors review patient presentation, physical examination, and work-up needed for diagnosis of this syndrome to help physicians avoid administering unnecessary tests and treatment.
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J Am Osteopath Assoc · Jul 2009
Improving the quality of suicide risk assessments in the psychiatric emergency setting: physician documentation of process indicators.
Suicide risk assessment in the emergency department is a challenging task for psychiatrists and is further complicated when patients are admitted involuntarily. ⋯ Many important risk factors for suicide were not documented in emergency department assessments, suggesting that overall quality of psychiatric risk assessments was not optimal. This lack of documentation has important implications from a treatment and medicolegal perspective.