Session Information
Session Title: AA 2022 Posters - General Rehabilitation
Session Time: None. Available on demand.
Disclosures: Sarah A. Eby, MD: No financial relationships or conflicts of interest
Case Diagnosis: Physiatric consultation is often underutilized in the acute hospital setting. We describe 5 cases that demonstrate the importance of having a physiatrist involved with diagnosis and management of neurologic, rheumatologic, vascular, spinal, and musculoskeletal conditions.
Case Description or Program Description: Case 1: 25-year-old female presented with acute right sided weakness and numbness with negative brain MRI. PM&R consultant noted hyperreflexia, clonus and bilateral weakness and recommended MRI cervical and thoracic spine which showed transverse myelitis. Symptoms improved with IV steroids and baclofen. Case 2: 83-year-old male presented with progressive arthralgias and generalized weakness. Diagnostics supported degenerative changes only. PM&R proposed polymyalgia rheumatica. Labs demonstrated significantly elevated inflammatory markers. Patient had marked improvement in symptoms with prednisone. Case 3: 35-year-old female with recent TIA presented with right upper extremity pain and paresthesia and negative brain MRI. PM&R noted absent right radial pulse, cool right extremity and recommended stat vascular surgery evaluation for poor perfusion. Arterial Doppler demonstrated right brachial artery thrombosis. Patient underwent brachial artery embolectomy with restoration of perfusion. Case 4: 47-year-old male presented with progressive bilateral lower extremity weakness and spasticity after a fall. MRI lumbar spine unrevealing. PM&R noted severe hypertonicity on exam and recommended MRI of the cervical and thoracic spine. MRI revealed a mass causing thoracic spinal cord compression and myelomalacia. He underwent urgent thoracic decompression and fusion. Case 5: 75-year-old male presented with left knee pain following a fall. X-ray demonstrated an effusion with significant soft tissue swelling without acute fracture. PM&R noted knee extension weakness and recommended knee MRI which demonstrated a full thickness quadriceps tendon rupture prompting surgical repair.
Setting: Community hospital.
Assessment/Results: See Above
Discussion (relevance): The cases above demonstrate the importance of having a physiatrist involved in the inpatient setting to assist with diagnosis and management of complex conditions.
Conclusions: The physiatrist plays an integral role in the acute hospital setting.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Eby SA, Courtney K, Bhasin S, Akpuaka B, Crane J. Good Catch: A Case Series Demonstrating the Importance of PM&R Consultation in the Acute Hospital Setting [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/good-catch-a-case-series-demonstrating-the-importance-of-pmr-consultation-in-the-acute-hospital-setting/. Accessed October 31, 2024.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/good-catch-a-case-series-demonstrating-the-importance-of-pmr-consultation-in-the-acute-hospital-setting/