DOI: 01/30/2012. This is a 41-year-old right-hand dominant male meat cutter who sustained injuries to the left arm, hand, and fingers and bilateral elbows due to repetitive job duties. The patient was subsequently diagnosed with left shoulder impingement syndrome. As per medical report dated 2/22/16, patient complains of left shoulder pain with overhead use of the arm as well as when forward reaching, noting the moderate pain at the left elbow. Physical examination revealed moderate tenderness to palpation is noted anteriorly over the rotator interval and at the acromioclavicular joint. Active range of motion of the shoulder is full with forward flexion in the plane of the scapula to 170 degrees, external rotation of 80 degrees, and internal
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Matthews. As per special report dated 7/22/16 notes that patient follows exhaustive conservative care, which included chronic use of extremity splinting, modified work related activities with further restrictions on activities of daily living, long-term use of anti-inflammatory medication, multiple dexamethasone injection to the affected body part; an appropriate course of physical therapy; and prior platelet-rich plasma injections on 9/16/15 and 4/28/16 with significant albeit nonsustained response. Additionally, the patient continues to have abnormal clinical findings including focal tenderness is present critical over the left lateral epicondyle and common extensor origin; negative radiographs of the elbow; no tenderness of the radial tunnel with a negative resisted supination and middle finger extension test. It was further noted that despite the extent of conservative care provided, the patient continues to be markedly symptomatic with the current level of symptoms precluding return to a full duty work status and many simple activities of daily living. Due to unrelenting symptoms, the patient strongly desires to proceed with the proposed
Matthews. As per special report dated 7/22/16 notes that patient follows exhaustive conservative care, which included chronic use of extremity splinting, modified work related activities with further restrictions on activities of daily living, long-term use of anti-inflammatory medication, multiple dexamethasone injection to the affected body part; an appropriate course of physical therapy; and prior platelet-rich plasma injections on 9/16/15 and 4/28/16 with significant albeit nonsustained response. Additionally, the patient continues to have abnormal clinical findings including focal tenderness is present critical over the left lateral epicondyle and common extensor origin; negative radiographs of the elbow; no tenderness of the radial tunnel with a negative resisted supination and middle finger extension test. It was further noted that despite the extent of conservative care provided, the patient continues to be markedly symptomatic with the current level of symptoms precluding return to a full duty work status and many simple activities of daily living. Due to unrelenting symptoms, the patient strongly desires to proceed with the proposed