Podiatric Surgeon s Primer on Thyroid Pathology and Entrapment Neuropathies
|
|
- Egbert Cobb
- 8 years ago
- Views:
Transcription
1 Podiatric Surgeon s Primer on Thyroid Pathology and Entrapment Neuropathies Damien M. Dauphinee, DPM, FACFAS, CWS-P Past President Association of Extremity Nerve Surgeons
2 Goals and Objectives Is there a relationship? Discuss the evidence in the literature Recommend options for treatment
3 Thyroid Pathology Hypo and hyperthyroidism Associated with clinical and electrodiag. Myopathy Mono-neuropathy Poly-neuropathy
4 Thyroid Pathology Hypothyroidism Associated with clinical and electrodiag. Myopathy (10-80%) Mono-neuropathy (5-65%) Poly-neuropathy (9-72%) Somay G, et al. Neuromuscular status of thyroid diseases: A prospective clinical and electrodiagnostic study. Electrmyogr. Clin. Neurophysiol., 2007, 47,
5 Hypothyroidism Carpal Tunnel Syndrome (CTS) Tarsal Tunnel Syndrome (TTS) Most common type of entrapment mononeuropathies Palumbo et al found 73% (31 hands) of 26 hypothyroid pts displayed symptoms of CTS, 16 pts (25 hands) in hyperthyroid pts had clinical symptoms of CTS. ALL SYMPTOMATIC PTS WERE EUTHYROID CTS remains common in thyroid pts even when they are euthyroid. Palumbo, CF, Szabo, RM, Olmsted, SL. et al. The effects of hypothyroidism and thyroid replacement on the development of carpal tunnel syndrome. J of Hand Surg. 2000:25: Schwartz, MS, Mackworth-Young, GG, McKeron, R. The tarsal tunnel syndrome in hypothyroidism. J Neurol Neurosurg Psychiatry, 1975; 38:
6 Thyroid Pathology Hypothyroidism Somay and colleagues looked at 40 cases of hypo (19 patients) and hyperthyroidism (21 patients) Control group was 29 healthy cases for upper extremities and 58 healthy cases for lower extremities. Somay G, et al. Neuromuscular status of thyroid diseases: A prospective clinical and electrodiagnostic study. Electrmyogr. Clin. Neurophysiol., 2007, 47,
7 Thyroid Pathology Somay et al study Complete histories and full lab work up for all individuals. CBC, glucose, BUN, creatinine, B12 and folic acid, CPK, CPK-MB, GOT, GPT and LDH levels. Excluded known diabetics, renal failure, liver failure, malignancy, low serum B12 and folic acid levels, pts using drugs or alcohol which could effect the nervous system or thyroid hormone levels Somay G, et al. Neuromuscular status of thyroid diseases: A prospective clinical and electrodiagnostic study. Electrmyogr. Clin. Neurophysiol., 2007, 47,
8 Thyroid Pathology Somay et al study Electrodiagnostic studies were performed. In the thyroid patients 30% showed evidence of entrapment mononeuropathy and diffuse peripheral neuropathy in 10%. 47% with hypothyroidism (38% with hyperthyroidism) showed electrophysiological abnormalities. Somay G, et al. Neuromuscular status of thyroid diseases: A prospective clinical and electrodiagnostic study. Electromyogr. Clin. Neurophysiol., 2007, 47,
9 Treatment Options Kecechi and Degimenchi studied 40 patients over 18 y/o All showed lab values hypothyroidic Electrodiagnostic evidence of CTS in 15 patients and polyneuropathy in 7 patients. After thyroid replacement 35 pts were showing normal electrodiagnostic findings Authors recommending 3 months of replacement before considering surgical options. Kecechi, H, Degirmenci, Y. Hormone replacement therapy in hypothyroidism and nerve conduction study. Neurophysiol Clin. 2006; 36(2):79-83.
10 Entrapment Neuropathy and Hypothyroidism Ramadhan et al looked at the literature Hypothyroidism, nontraumatic common peroneal compression Reported a case of CPN entrapment syndrome in patient with thyroid hormone withdrawal in the presence of diabetes. Ramadhan A, Schondorf R, Tamilia M. Rhabdomyolysis and peroneal nerve compression associated with thyroid withdrawal in the setting of remnant ablation: review of the literature. Endocr Pract Jul- Aug;17(4):
11 Duyff et al looked 45 pts 24 hypo and 21 hyperthyroid Newly diagnosed Excluded other causes of neuropathy like DM, alcoholism, liver and kidney dz, use of drugs known to cause neuropathy, malignancy, fam hx of neuropathy. Duyff RF, et al. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 2000;68:
12 Duyff et al looked 45 pts 33% of hypothyroid pts had residual symptoms and signs after 1 year of therapy. Prevalence of clinical and electrodiagnostically confirmed CTS was 25%. Duyff RF, et al. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 2000;68:
13 Etiology? Hypothesized that the mucinous material accummulations within the nerves and peripheral tissues accounts for the onset and progression of CTS and TTS. Schwartz, MS, Mackworth-Young, GG, McKeron, R. The tarsal tunnel syndrome in hypothyroidism. J Neurol Neurosurg Psychiatry, 1975; 38:
14 Mononeuropathy in Hypothyroid Patient: now what? Ducic, Taylor and Dellon showed that neurolysis of the four medial nerve tunnels (tibial, medial calc, medial and lateral plantar). Improved pedal sensibility and balance 7% were hypothyroid patients Positive Tinel sign was an excellent predictor for which patients would benefit from surgery Ducic I, Taylor NS, Dellon AL. Relationship between peripheral nerve decompression and gain of pedal sensibility and balance in patients with peripheral neuropathy. Ann of Plast Surg. Feb;56(2): , 2006.
15 Take Home Message When you see pts with thyroid disease Inquire about symptoms of peripheral nerve pathology Burning, tingling, lancinating pain (paresthesias) If they have been euthyroid for >3 months and continue to have symptoms and + Tinel Consider referring them to a peripheral nerve specialist
Heel Pain Syndromes DELLON INSTITUTES FOR PERIPHERAL NERVE SURGERY
Heel Pain s 5 3333 N CALVERT ST, SUITE 370, BALTIMORE, MD 21218 T410 467 5400 F410 366 9826 delloninstitutes.com your complaints are Pain, numbness or burning in your heel. The timing of this pain and
More informationUsefulness of Electrodiagnostic Techniques in the Evaluation of Suspected Tarsal Tunnel Syndrome: An Evidence-based Review
Usefulness of Electrodiagnostic Techniques in the Evaluation of Suspected Tarsal Tunnel Syndrome: An Evidence-based Review Reviewed 07/08 CME Available 7/08-7/11 No one involved in the planning of this
More informationAetna Nerve Conduction Study Policy
Aetna Nerve Conduction Study Policy Policy Aetna considers nerve conduction velocity (NCV) studies medically necessary when both of the following criteria are met: 1. Member has any of the following indications:
More informationGroin Pain Syndromes
Groin Pain s 4 3333 N CALVERT ST, SUITE 370, BALTIMORE, MD 21218 T410 467 5400 F410 366 9826 delloninstitutes.com your compaints are Pain, numbness or burning in the lower abdominal wall, and/or the pubic
More informationRole of Electrodiagnostic Tests in Neuromuscular Disease
Role of Electrodiagnostic Tests in Neuromuscular Disease Electrodiagnostic tests Electroencephalogram (EEG) Electromyography (NCV, EMG) Cerebral evoked potentials (CEP) Motor evoked potentials (MEP) Electronystagmogram
More informationa) Nerve conduction studies (NCS) test the peripheral nervous system for:
Health Plan Coverage Policy ARBenefits Approval: 11/02/2011 Effective Date: 01/01/2012 Revision Date: 09/18/2013 Comments: Code additions only. Title: Electrodiagnostic Testing Document: ARB0256 Public
More informationELECTROMYOGRAPHY (EMG), NEEDLE, NERVE CONDUCTION STUDIES (NCS) AND QUANTITATIVE SENSORY TESTING (QST)
AND QUANTITATIVE SENSORY TESTING (QST) Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Medical
More informationTreatment of Recalcitrant Intermetatarsal Neuroma With 4% Sclerosing Alcohol Injection: A Pilot Study
Treatment of Recalcitrant Intermetatarsal Neuroma With 4% Sclerosing Alcohol Injection: A Pilot Study Christopher F. Hyer, DPM,' Lynette R. Mehl, DPM,2 Alan J. Block, DPM, MS, FACFAS,3 and Robert B. Vancourt,
More informationPrevention of Foot Ulceration and Amputation. By Decompression of Peripheral Nerves. In Patients with Diabetic Neuropathy
Prevention of Foot Ulceration and Amputation By Decompression of Peripheral Nerves In Patients with Diabetic Neuropathy A. Lee Dellon, MD Professor of Plastic Surgery and Neurosurgery Johns Hopkins University
More informationHeel Pain: Heal! Amie C. Scantlin, DPM, MS, FACFAS Glencoe Regional Health Services (320) 864-3121 ext. 1933
Heel Pain: Heal! Amie C. Scantlin, DPM, MS, FACFAS Glencoe Regional Health Services (320) 864-3121 ext. 1933 www.grhsonline.org Important Notice The information contained in this document is for informational
More informationMs. Jackson is the Manager of Health Finance and Reimbursement, Division of Health Policy and Practice Services, Washington, DC.
Electrodiagnostic Testing with Same Day Evaluation Management By: Shane J. Burr, MD; Scott I. Horn, DO; Jenny J. Jackson, MPH, CPC; Joseph P. Purcell, DO Dr. Burr practices general inpatient and outpatient
More information3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing
3nd Biennial Contemporary Clinical Neurophysiological Symposium October 12, 2013 Fundamentals of NCS and NMJ Testing Peter D. Donofrio, M.D. Professor of Neurology Vanderbilt University Medical Center
More informationISSN 2347-954X (Print) Research Article. *Corresponding author Dr. Abhijeet A. Adgaonkar Email:
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2014; 2(6A):1973-1977 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationPlantar fasciitis is a common foot problem that occurs in 10%
Review Article Plantar Fasciitis Heel Pain: Part 1 a Practical Management Plantar fasciitis is a common foot problem that occurs in 10% of the population. 1,2 The most involved age group is 40-50 3,4 Actually,
More informationProximal border = palmar wrist crease Distal border = Kaplan + ring finger axis
FPL FCR Proximal border = palmar wrist crease Distal border = Kaplan + ring finger axis Thenar motor branch Kaplan s cardinal line: distal TCL thenar branch Superficial palmar arch superficial arch Originates
More informationName of Policy: Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies
Name of Policy: Neuromuscular and Electrodiagnostic Testing (EDX): Nerve Conduction Studies (NCS) and Electromyography (EMG) Studies Policy #: 228 Latest Review Date: August 2015 Category: Medicine Policy
More informationNot applicable. Medical Coverage Policy Automated Point-of-Care Nerve Conduction EFFECTIVE DATE: 03 03 2015 POLICY LAST UPDATED: 03 03 2015
Medical Coverage Policy Automated Point-of-Care Nerve Conduction EFFECTIVE DATE: 03 03 2015 POLICY LAST UPDATED: 03 03 2015 OVERVIEW Portable devices have been developed to provide point-of-care nerve
More informationInformed Patient Tutorial Copyright 2012 by the American Academy of Orthopaedic Surgeons
Informed Patient Tutorial Copyright 2012 by the American Academy of Orthopaedic Surgeons Informed Patient - Carpal Tunnel Release Surgery Introduction Welcome to the American Academy of Orthopaedic Surgeons'
More informationDecember 29, 2012. Dear Acting Administrator Tavenner:
December 29, 2012 Marilyn B. Tavenner Acting Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Attention: CMS-1590-FC P.O. Box 8013 Baltimore, MD 21244
More informationRECOMMENDATIONS. INVESTIGATION AND MANAGEMENT OF PRIMARY THYROID DYSFUNCTION Clinical Practice Guideline April 2014
INVESTIGATION AND MANAGEMENT OF PRIMARY THYROID DYSFUNCTION Clinical Practice Guideline April 2014 OBJECTIVE Alberta clinicians optimize laboratory testing for the investigation and management of primary
More informationUnderstanding. Peripheral Neuropathy. Lois, diagnosed in 1998, with her husband, Myron.
Understanding Peripheral Neuropathy Lois, diagnosed in 1998, with her husband, Myron. What Is Peripheral Neuropathy? Peripheral neuropathy is a nerve disorder. It may cause numbness, tingling, and weakness.
More informationMedStar Health, Inc. POLICY AND PROCEDURE MANUAL
MedStar Health, Inc. POLICY AND PROCEDURE MANUAL SUBJECT: Nerve Conduction Velocity Studies/Electrodiagnostic INDEX TITLE: Studies/Neuromuscular Medical Management Junction Testing ORIGINAL DATE: March
More informationThings You Don t Want to Miss in Multiple Myeloma
Things You Don t Want to Miss in Multiple Myeloma Sreenivasa Chandana, MD, PhD Attending Hematologist and Medical Oncologist West Michigan Cancer Center Assistant Professor, Western Michigan University
More informationELECTRODIAGNOSTIC MEDICINE
ELECTRODIAGNOSTIC MEDICINE OBJECTIVES BEGINNER Patient Care Perform a comprehensive electrodiagnostic evaluation of each patient and to provide a concise diagnosis and plan for further treatment Describe
More informationElectrodiagnostic Testing
Electrodiagnostic Testing Electromyogram and Nerve Conduction Study North American Spine Society Public Education Series What Is Electrodiagnostic Testing? The term electrodiagnostic testing covers a
More informationEMG and the Electrodiagnostic Consultation for the Family Physician
EMG and the Electrodiagnostic Consultation for the Family Physician Stephanie Kopey, D.O., P.T. 9/27/15 The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) Marketing Committee
More informationRadiculopathy vs. Peripheral Neuropathy. What to do with arm pain? Defining Arm Pain. Arm Pain
Radiculopathy vs. Peripheral Neuropathy What to do with arm pain? Miriana G. Popadich RN, MSN Clinical Care Coordinator Brachial Plexus Program Department of Neurosurgery University of Michigan Timing
More informationSUMMARY. Carpal tunnel syndrome; Permanent impairment [NEL] (rating schedule) (AMA Guides) (functional impairment).
SUMMARY DECISION NO. 1033/98 Carpal tunnel syndrome; Permanent impairment [NEL] (rating schedule) (AMA Guides) (functional impairment). The worker was a stope miner for four years beginning in 1987. In
More informationPreventing Potential Claims of Negligence What Would You Do Settle or Go to Trial?
Preventing Potential Claims of Negligence What Would You Do Settle or Go to Trial? Ross E. Taubman, DPM PICA President and Chief Medical Officer 2013 APMA YOUNG PHYSICIANS INSTITUTE April 12 14 PICA Headquarters
More informationSymptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries
1 Symptoms and Signs of Irritation of the Brachial Plexus in Whiplash Injuries J Bone Joint Surg (Br) 2001 Mar;83(2):226-9 Ide M, Ide J, Yamaga M, Takagi K Department of Orthopaedic Surgery, Kumamoto University
More informationHow To Know If You Can Get A Carpal Tunnel Injury Compensation
U. S. DEPARTMENT OF LABOR Employees Compensation Appeals Board In the Matter of BARBARA SNYDER and DEPARTMENT OF THE TREASURY, INTERNAL REVENUE SERVICE, Germansville, PA Docket No. 03-1467; Submitted on
More informationA Patient s Guide to Carpal Tunnel Syndrome
A Patient s Guide to Carpal Tunnel Syndrome 651 Old Country Road Plainview, NY 11803 Phone: 5166818822 Fax: 5166813332 p.lettieri@aol.com DISCLAIMER: The information in this booklet is compiled from a
More informationUBC Pain Medicine Residency Program: CanMEDS Goals and Objectives of the Neurology Rotation
UBC Pain Medicine Residency Program: CanMEDS Goals and Objectives of the Neurology Rotation Goals of the Program To acquire the knowledge and skills necessary to assess and provide a management plan for
More informationNeuromuscular Medicine Fellowship Curriculum
Neuromuscular Medicine Fellowship Curriculum General Review Goals and Objectives Attend weekly EMG sessions as assigned Take a Directed History and Exam of each EMG patient Attend every other week Muscle
More information2.01.77. Description. Section: Medicine Effective Date: October 15, 2014 Subsection: Medicine Original Policy Date: December 7, 2011 Subject:
Last Review Status/Date: September 2014 Page: 1 of 11 Description Portable devices have been developed to provide point-of-care nerve conductions studies. These devices have computational algorithms that
More informationSpinal Cord Stimulation (SCS) Therapy: Fact Sheet
Spinal Cord Stimulation (SCS) Therapy: Fact Sheet What is SCS Therapy? Spinal cord stimulation (SCS) may be a life-changing 1 surgical option for patients to control their chronic neuropathic pain and
More informationAtrial Fibrillation (AF) March, 2013
Atrial Fibrillation (AF) March, 2013 This handout is meant to help with discussions about the condition, and it is not a complete discussion of AF. We hope it will complement your appointment with one
More informationTopic: Automated Point-of-Care Nerve Conduction Studies Date of Origin: April 3, 2007. Section: Medicine Last Reviewed Date: December 2014
Medical Policy Manual Topic: Automated Point-of-Care Nerve Conduction Studies Date of Origin: April 3, 2007 Section: Medicine Last Reviewed Date: December 2014 Policy No: 128 Effective Date: March 1, 2015
More informationBilling and Coding Guidelines: NEURO-005 Nerve Conduction Studies and Electromyography. Contractor Name Wisconsin Physicians Service (WPS)
Billing and Coding Guidelines: NEURO-005 Nerve Conduction Studies and Electromyography Contractor Name Wisconsin Physicians Service (WPS) Contractor Number 00951, 00952, 00953, 00954 05101, 05201, 05301,
More informationCURRICULUM VITAE. Syed M. Zaffer, M.D. 13020 Telecom Parkway N. Temple Terrace, FL 33637-0925 Tel: (813) 978-9700 ext. 6739 Fax: 813-558-6174
CURRICULUM VITAE Syed M. Zaffer, M.D. 13020 Telecom Parkway N. Temple Terrace, FL 33637-0925 Tel: (813) 978-9700 ext. 6739 Fax: 813-558-6174 PERSONAL DATA: Date of Birth: November 22, 1965 Place of Birth:
More informationAdams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS
Adams Memorial Hospital Decatur, Indiana EXPLANATION OF LABORATORY TESTS Your health is important to us! The test descriptions listed below are for educational purposes only. Laboratory test interpretation
More informationChapter 3. Approach to the tibial nerve. Based on. Dellon AL, Dackinnon SD, Tibial nerve branching in the tarsal tunnel. Arch Neurol, 41:645-646, 1984
Based on Dellon AL, Dackinnon SD, Tibial nerve branching in the tarsal tunnel. Arch Neurol, 41:645-646, 1984 Dellon AL, Computer-assisted sensibility evaluation and surgical treatment of tarsal tunnel
More informationOriginal Policy Date
MP 2.01.50 Automated Point-of-Care Nerve Conduction Tests Medical Policy Section Medicine Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date Reviewed with literature review/12:2013 Return
More informationCENTER FOR HEALTH AND SAFETY IN THE WORKPLACE
CENTER FOR HEALTH AND SAFETY IN THE WORKPLACE A study by the RAND Institute for Civil Justice and RAND Health CHILDREN AND FAMILIES EDUCATION AND THE ARTS ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE
More informationGuidelines for Clinical Neurophysiology
Guidelines for Clinical Neurophysiology These Guidelines have been drawn up along the lines of those of the Department of Clinical Radiology to help referring clinicians make the best use of Clinical Neurophysiology.
More informationEMG AND NCS: A PRACTICAL APPROACH TO ELECTRODIAGNOSTICS
EMG AND NCS: A PRACTICAL APPROACH TO ELECTRODIAGNOSTICS Dr. Harp Sangha, Dr. Tania R. Bruno Staff Physiatrists Toronto Rehab UHN Lecturers, Department of Medicine University of Toronto February 1, 2013
More informationElectromyography and Nerve Conduction Studies
Electromyography and Nerve Conduction Studies Policy Number: 2.01.95 Last Review: 10/2015 Origination: 10/2015 Next Review: 10/2016 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide
More informationCARPAL TUNNEL SYNDROME A PATIENT GUIDE TO THE NURSE-LED CARPAL TUNNEL SERVICE
CARPAL TUNNEL SYNDROME A PATIENT GUIDE TO THE NURSE-LED CARPAL TUNNEL SERVICE Information Leaflet Your Health. Our Priority. Page 2 of 6 What is carpal tunnel syndrome? It is entrapment of a nerve at the
More informationDisclosure: I have nothing to disclose
Disclosure: I have nothing to disclose Pectoralis Minor Syndrome Definition Hand and arm symptoms due to Compression of Axillary neurovascular bundle by Pec Minor Muscle Pectoralis Minor Syndrome Short
More informationDifferentiating Cervical Radiculopathy and Peripheral Neuropathy. Adam P. Smith, MD
Differentiating Cervical Radiculopathy and Peripheral Neuropathy Adam P. Smith, MD I have no financial, personal, or professional conflicts of interest to report Radiculopathy versus Neuropathy Radiculopathy
More informationCarpal Tunnel Syndrome Medical Treatment Guidelines Proposed by the State of New York Department of Insurance to the Workers Compensation Board
Carpal Tunnel Syndrome Medical Treatment Guidelines Proposed by the State of New York Department of Insurance to the Workers Compensation Board July 2011 Draft TABLE OF CONTENTS I. INTRODUCTION 1 II. HISTORY
More informationEfficacy of Short-term Low Dose Oral Steroid in Carpal Tunnel Syndrome
Efficacy of Short-term Low Dose Oral Steroid in Carpal Tunnel Syndrome *Alam MM, 1 Bari MS, 2 Ullah AK, 3 Haque A, 4 Sardar AH, 5 Mohammad KD 6 To determine the efficacy of four weeks course of oral steroid
More informationNerve Conduction Velocity (NCV) & Electromyography (EMG) Studies
Nerve Conduction Velocity (NCV) & Electromyography (EMG) Studies [Preauthorization Required] Medical Policy: MP-ME-09-09 Original Effective Date: November 5, 2010 Reviewed: November 5, 2010 Reviewed: November
More informationJoint Pain: Wrist, Knee, Shoulder, Ankle, Elbow, TMJ
Joint Pain: Wrist, Knee, Shoulder, Ankle, Elbow, TMJ 6 3333 N CALVERT ST, SUITE 370, BALTIMORE, MD 21218 T410 467 5400 F410 366 9826 delloninstitutes.com your complaints are Your wrist hurts when you bend
More informationImplementing Medical Checkups to Prevent. Sports-Related Injuries and Disorders
Sports-Related Injuries and Disorders Implementing Medical Checkups to Prevent Sports-Related Injuries and Disorders JMAJ 48(1): 1 5, 2005 Hideo MATSUMOTO*, Toshiro OTANI**, Hitoshi ABE*** and Yasunori
More informationAPPENDIX F INTERJURISDICTIONAL RESEARCH
Ontario Scheduled Presumption: Bursitis, listed in Schedule 3, of the Ontario Workers Compensation Act, entry number 18 Description of Disease Bursitis Process Any process involving constant or prolonged
More informationCARPAL TUNNEL SYNDROME
CARPAL TUNNEL SYNDROME Background 1. Definition: Entrapment neuropathy of median nerve as it courses through carpal tunnel o Stage I: Predominantly nocturnal symptoms of numbness and /or tingling in fingers
More informationIN THE SUPREME COURT OF TENNESSEE SPECIAL WORKERS= COMPENSATION APPEALS PANEL AT MEMPHIS March 25, 2015 Session
IN THE SUPREME COURT OF TENNESSEE SPECIAL WORKERS= COMPENSATION APPEALS PANEL AT MEMPHIS March 25, 2015 Session WILLIAM DeMORATO V. CHEROKEE INSURANCE CO. Appeal from the Chancery Court for Madison County
More informationWORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1525/07
WORKPLACE SAFETY AND INSURANCE APPEALS TRIBUNAL DECISION NO. 1525/07 BEFORE: HEARING: M. Crystal: Vice-Chair June 29, 2007 at Toronto Oral hearing DATE OF DECISION: July 3, 2007 NEUTRAL CITATION: 2007
More informationCLINICAL NEUROPHYSIOLOGY
CLINICAL NEUROPHYSIOLOGY Barry S. Oken, MD, Carter D. Wray MD Objectives: 1. Know the role of EMG/NCS in evaluating nerve and muscle function 2. Recognize common EEG findings and their significance 3.
More informationCarpal Tunnel Release. Relieving Pressure in Your Wrist
Carpal Tunnel Release Relieving Pressure in Your Wrist Understanding Carpal Tunnel Syndrome Carpal tunnel syndrome (CTS) is a problem that affects the wrist and hand. If you have CTS, tingling and numbness
More informationTeriflunomide (Aubagio) 14mg once daily tablet
Teriflunomide (Aubagio) 14mg once daily tablet Exceptional healthcare, personally delivered Your Consultant Neurologist has suggested that you may benefit from treatment with Teriflunomide. The decision
More informationCHPN Review Course Pain Management Part 1 Hospice and Palliative Nurses Association
CHPN Review Course Pain Management Part 1 Disclosures Bonnie Morgan has no real or perceived conflicts of interest that relate to this presentation. Copyright 2015 by the. HPNA has the exclusive rights
More informationINITIATING ORAL AUBAGIO (teriflunomide) THERAPY
FOR YOUR PATIENTS WITH RELAPSING FORMS OF MS INITIATING ORAL AUBAGIO (teriflunomide) THERAPY WARNING: HEPATOTOXICITY AND RISK OF TERATOGENICITY Severe liver injury including fatal liver failure has been
More informationAutomated Point-of-Care Nerve Conduction Tests
MEDICAL POLICY POLICY RELATED POLICIES POLICY GUIDELINES DESCRIPTION SCOPE BENEFIT APPLICATION RATIONALE REFERENCES CODING APPENDIX HISTORY Automated Point-of-Care Nerve Conduction Tests Number 2.01.77
More informationMedical Report Checklist: Upper Extremities Peripheral Nerve Disorders Impairments (PND)
http://www.pdratings.com/ Craig Andrew Lange craig@pdratings.com California Workers Compensation Certified AMA Guides Impairment & Disability Rating Specialists Voice: (415) 861-4040 / Fax: (415) 276-3741
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Alcohol Injection Therapy for Morton s Neuroma Page 1 of 7 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Alcohol Injection Therapy for Morton s Neuroma Professional
More informationDisability Evaluation Under Social Security
Disability Evaluation Under Social Security Revised Medical Criteria for Evaluating Endocrine Disorders Effective June 7, 2011 Why a Revision? Social Security revisions reflect: SSA s adjudicative experience.
More informationPlantar Heel Pain. By: Kevin Kleiner, M.B.S. New York College of Podiatric Medicine
Plantar Heel Pain By: Kevin Kleiner, M.B.S. New York College of Podiatric Medicine Plantar Heel Pain: - Many Etiologies but few solutions Plantar heel pain more specifically: Heel pain felt in ones rear-foot
More informationFact Sheet. Queensland Spinal Cord Injuries Service. Pain Management Following Spinal Cord Injury for Health Professionals
Pain Management Following Injury for Health Professionals and Introduction Pain is a common problem following SCI. In the case where a person with SCI does have pain, there are treatments available that
More informationNOT DESIGNATED FOR PUBLICATION
NOT DESIGNATED FOR PUBLICATION BEFORE THE ARKANSAS WORKERS' COMPENSATION COMMISSION CLAIM NO. F503749 EVLYNENE KIRKENDOLPH, EMPLOYEE C L A I M ANT DF&A REVENUE SERVICES DIVISION/ OFFICE OF CHILD SUPPORT
More informationManagement of Neurologically Intact Patient with Cervical Epidural Abscess
Management of Neurologically Intact Patient with Cervical Epidural Abscess Jason C. Eck, DO, MS Center for Sports Medicine & Orthopaedics Chattanooga, TN Overview Pathophysiology and epidemiology of epidural
More informationNerve Decompression for Complex Regional Pain Syndrome Type II Following Upper Extremity Surgery
Nerve Decompression for Complex Regional Pain Syndrome Type II Following Upper Extremity Surgery Jeffrey D. Placzek, MD, St. Louis, MO, Rochester, MI, Martin I. Boyer, MD, Richard H. Gelberman, MD, Barbara
More informationDiagnosis, Causation and Treatment of Carpal Tunnel Syndrome: An Evidence-Based Assessment
Diagnosis, Causation and Treatment of Carpal Tunnel Syndrome: An Evidence-Based Assessment May 2004 A Background Paper Prepared for Alberta's Workers' Compensation Board Diagnosis, Causation and Treatment
More information5/13/2013. Evaluation of Peripheral Nervous System Dysfunction. Disclosures. Peripheral Nervous System
Evaluation of Peripheral Nervous System Dysfunction Christian M. Custodio, M.D. Cancer Rehabilitation Fellowship Director Memorial Sloan-Kettering Cancer Center Assistant Professor Weill Cornell Medical
More informationMEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING
MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING WHAT IS RISK ADJUSTMENT? Risk Adjustment ensures that accurate payments are made to Medicare Advantage
More informationPain Management. Practical Applications in Electrotherapy
Pain Management Practical Applications in Electrotherapy The TENS Advantage Deliver Immediate Pain Relief using a unique waveform designed to help prevent nerve accommodation. Manage Dynamic Pain by adjusting
More informationVEIN-GRAFT WRAPPING FOR THE TREATMENT OF RECURRENT COMPRESSION OF THE MEDIAN NERVE
VEIN-GRAFT WRAPPING FOR THE TREATMENT OF RECURRENT COMPRESSION OF THE MEDIAN NERVE DEAN G. SOTEREANOS, M.D., PANAYOTIS NoGIANNAKOPOULOS, M.D., GRIGORISI. MITSIONIS, M.D.,JIANGMING XU, M.D.,and JAMES H.
More informationoptimal use of thyroid function tests (TFTs) to diagnose and monitor thyroid disease.
Guidance for Thyroid Function Testing in Primary Care in Lothian In July 2006 following a lengthy consultation process, a joint working group comprising representatives from the Association of Clinical
More informationFORGET ME NOT: The Triple Arthrodesis
C H A P T E R 1 5 FORGET ME NOT: The Triple Arthrodesis Andrea D. Cass, DPM INTRODUCTION The triple arthrodesis is a procedure that is performed much less commonly for the same conditions as it was 20
More informationCTS the Best EDX. Ernest W Johnson MD Emeritus Professor Physical Medicine & Rehabilitation The Ohio State University
CTS the Best EDX Ernest W Johnson MD Emeritus Professor Physical Medicine & Rehabilitation The Ohio State University 1 Definition of CTS A syndrome 2d to dysfunction of median nerve in carpal tunnel resulting
More informationHypothyroidism clinical features and treatment. 1. The causes of hypothyroidism
Hypothyroidism clinical features and treatment 1. The causes of hypothyroidism The thyroid is a gland in the neck which makes two thyroid hormones, thyroxine (T4) and tri-iodothyronine (T3). Thyroxine
More informationThyroid Eye Disease (TED)
Manchester Royal Eye Hospital Thyroid Eye Disease (TED) Information For Patients 2 What is Thyroid Eye Disease (TED)? The thyroid gland is located in the neck and produces a hormone that helps regulate
More informationThymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available.
Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against
More informationThe Brain and Spine CenTer
The Br ain and Spine Center Choosing the right treatment partner is important for patients facing tumors involving the brain, spine or skull base. The Brain and Spine Center at The University of Texas
More informationUnderstanding. Pancreatic Cancer
Understanding Pancreatic Cancer Understanding Pancreatic Cancer The Pancreas The pancreas is an organ that is about 6 inches long. It s located deep in your belly between your stomach and backbone. Your
More informationWALKING BOOTS WALKING BOOTS. AFO s: Provider vs Prescriber? Provider. Prescriber
Douglas H. Richie, Jr., D.P.M. 550 Pacific Coast Highway Suite 209 Seal Beach, California 90740 562.493.2451 phone 562.596.3157 fax DRichieJr@aol.com WALKING BOOTS Definitions: L 4360 (defined by HCPS):
More informationMyeloma pathways to diagnosis UCLP audit
Myeloma pathways to diagnosis UCLP audit Dr Neil Rabin Consultant Haematologist University College London Hospitals & North Middlesex University Hospital Myeloma Clinical Features Bone pain (70%) High
More informationNot applicable. Medical Coverage Policy Automated Point of- Care Nerve Conduction Tests EFFECTIVE DATE: 09 01 2016 POLICY LAST UPDATED: 07 19 2016
Medical Coverage Policy Automated Point of- Care Nerve Conduction Tests EFFECTIVE DATE: 09 01 2016 POLICY LAST UPDATED: 07 19 2016 OVERVIEW Portable devices have been developed to provide point-of-care
More informationLATE RESPONSES IN MEDIAN NERVE ENTRAPMENT NEUROPATHY IN THE CARPAL TUNNEL
Bulletin of the Transilvania University of Braşov Series VI: Medical Sciences Vol. 7 (56) No.2-2014 LATE RESPONSES IN MEDIAN NERVE ENTRAPMENT NEUROPATHY IN THE CARPAL TUNNEL A. M. GALAMB 1 I. D. MINEA
More informationMedical Treatment Guidelines Washington State Department of Labor and Industries
Medical Treatment Guidelines Washington State Department of Labor and Industries Work-Related Ulnar Neuropathy at the Elbow (UNE) Diagnosis and Treatment* I. Introduction Table of Contents II. III. Establishing
More information19. Carpal Tunnel Syndrome
EVIDENCE-BASED MEDICINE Evidence-Based Interventional Pain Medicine according to Clinical Diagnoses 1. Carpal Tunnel Syndrome Jacob Patijn, MD, PhD*; Ricardo Vallejo, MD, PhD, FIPP ; Markus Janssen, MD*;
More informationBig Bad Data. FMSRE Results Presentation
FMSRE Results Presentation Big Bad Data Student: Matthew MacAllister MSII Mentor & PI : James Mold, MD, MPH Investigator: Frank Wu, MD, PHD Special thanks to the Department of Family and Preventive Medicine
More informationBEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT
BEFORE THE ARKANSAS WORKERS COMPENSATION COMMISSION CLAIM NUMBER F205928 DOUGLAS EUGENE WHIPKEY, EMPLOYEE CLAIMANT XPRESS BOATS, EMPLOYER RESPONDENT CONTINENTAL CASUALTY CO., INSURANCE CARRIER RESPONDENT
More informationBREAST CANCER AWARENESS FOR WOMEN AND MEN by Samar Ali A. Kader. Two years ago, I was working as a bedside nurse. One of my colleagues felt
Ali A. Kader, S. (2010). Breast cancer awareness for women and men. UCQ Nursing Journal of Academic Writing, Winter 2010, 70 76. BREAST CANCER AWARENESS FOR WOMEN AND MEN by Samar Ali A. Kader Two years
More informationINTRODUCTION TO HEALTH CAREERS
INTRODUCTION TO HEALTH CAREERS Pre-Health Advising Nicole Labrecque-Blue, Program Manager Abby Voss, Assistant Director We don t just advise pre-med Agenda Exploration Resources Introduction to a few Healthcare
More informationGrupo CHRISTUS MUGUERZA
Grupo CHRISTUS MUGUERZA Information about: Laparoscopic Adjustable Gastric Banding (Lap Band Surgery) For International Patients Grupo CHRISTUS MUGUERZA / Pág. 1 INDEX About Lap Band Surgery.... 3 Characteristics..
More information