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Left Arm And Neck Pain After Car Accident
Consult Page
73yF passenger in an MVC p/w neck and LUE pain. L C6-7 perched facet on CT.
Initial Imaging
Walking Thoughts
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What was the mechanism of the accident? Was the patient wearing a seat belt?
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Has the patient been evaluated by the trauma team?
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What other injuries does she have, and which is the most critical?
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Any concern for intracranial injury?
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What is her current clinical and neurological status? Is she hemodynamically stable?
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Does she have any previous medical problems, surgeries, or medications (e.g. anticoagulants and antiplatelets) that complicate her management?
History of Present Illness
A 72 year old female in good health presents with neck and left arm pain after a motor vehicle accident 3 hours prior. She was a belted passenger of a sedan when her vehicle rear-ended another at approximately 20 miles per hour. She felt her neck snap forward. She denies loss of consciousness or head strike. She immediately felt severe neck pain radiating down to her left arm and fingertips. She was brought to her local emergency department, where she was found to have an “abnormal x-ray” of her neck, and then transferred to our tertiary trauma center.
She currently reports 4 out of 10 neck pain, tingling and numbness radiating down the left arm into her fingers, and mild weakness in her left arm. She denies pain, abnormal sensation or weakness anywhere else and reports no new bowel or bladder dysfunction since the accident. She denies any anticoagulant or antiplatelet use. The trauma team has assessed her, and she has no other injuries. Her head CT is unremarkable.
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