The Ideal Patient With Low Back Pain
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
1y ago
Low back pain is very common, and the majority of the patients get better with time. The ideal patient will get better with time and has no radiation below the knee, no history of trauma, no fever or chills or weight loss, no bladder or bowel dysfunction, no neurological deficits, and no pathological reflexes. In order to optimize recovery, management of the patient should consist of early return to activity as tolerated, as the symptoms allow. You will give the patient reassurance with limited analgesia, early range of motion, and muscle relaxants. A healthy patient with an acute onset of no ..read more
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Ankle fracture Maisonneuve Fracture – Everything You Need to Know
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
1y ago
Maisonneuve fracture involves fracture of the proximal fibula associated with an occult and unstable injury of the ankle. The problem in these patients occur when the ankle injury is presented without a fracture of the lateral malleolus, or the medial malleolus and the injury is mistakenly diagnosed as an ankle sprain and the proximal fibular fracture is missed. Examine the leg for tenderness in the proximal fibula to diagnose a proximal fibula fracture. The patient could be mistakenly treated for having an isolated proximal fibular fracture alone and the ankle injury is missed.  High ind ..read more
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The Ideal Patient with Low Back Pain – Everything You Need to Know
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
1y ago
The ideal Patient with Low Back Pain – Everything you need to know Low back pain is very common, and the majority of the patients get better with time. The ideal patient will get better with time and has no radiation below the knee, no history of trauma, no fever or chills or weight loss, no bladder or bowel dysfunction, no neurological deficits, and no pathological reflexes. In order to optimize recovery, management of the patient should consist of early return to activity as tolerated, as the symptoms allow. You will give the patient reassurance with limited analgesia, early range of motion ..read more
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Frozen Shoulder – Adhesive Capsulitis
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Frozen Shoulder Adhesive Capsulitis – Everything You Need To Know Frozen shoulder (adhesive capsulitis) The frozen shoulder can be associated with diabetes or thyroid disease.  It may be the initial presenting symptom for these conditions.  The exact details of this relationship remain poorly understood.  Ever patient with a frozen shoulder should have the HbA1c and TSH levels tested.  Also, check for arthritis, rheumatoid factors and antinuclear antibodies.  Most patients with frozen shoulder are female between the ages of 40 and 60 years old ..read more
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Ankle Arthritis
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Ankle Arthritis – Everything You Need To Know – Dr. Nabil Ebraheim The patient will have longstanding global pain that is inside the ankle.  The patient will have antalgic gait with swelling of the ankle and decreased ankle motion.  You want to check the sensation.  Lack of sensation with Simmons–Weinstein 5.07 monofilament testing is important because insensate patients are poor candidates for ankle joint replacement.  The patient will usually have a trial of nonsurgical treatment first. Treatment          Anti-inflammatory me ..read more
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Differential Diagnosis of Spinal Stenosis
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Written by: Vihan DeSilva with Dr. Nabil Ebraheim Spinal stenosis is a diagnosis mainly made through history and CT/MRI imaging as physical exam findings can be normal namely in lumbar spinal stenoses. A common finding along with painful extension of the spine and decreased lumbar lordosis is narrowing of the spinal foramina, but diagnosis is made when patients present with neurogenic claudication and/or cervical myelopathy. The cause may be congenital or acquired through, for example, endocrinopathies, calcium metabolism disorders, inflammatory diseases, and infectious diseases.1,2 There ..read more
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Physical Exam of the Lower Spine and Lower Extremities
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Written by Travis Brege with Dr. Nabil Ebraheim The steps of any orthopedic examination will follow the pattern of inspection, palpation, range of motion, and tests of strength for the key groups of muscles applying all the appropriate provocative tests and neurovascular examinations.  First, in the inspection of the spine, look for any visible deformities in the coronal (frontal) and sagittal (longitudinal) planes. In the coronal plane, check for scoliosis and pelvic obliquity1. In the sagittal plane, check for normal cervical lordosis, thoracic kyphosis, and lumbar lordosis2. While asse ..read more
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Spine Exam: Neck and Upper Extremity
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
 Written by Ryan Jones with Dr. Nabil Ebraheim Neck and upper extremities spine examination or cervical spine physical examination involves assessment of vertebrae C3-T2, cranial nerve roots C4-T1, and all the muscles innervated by these nerve roots along with the muscles associated with basic neck movement. This examination follows the typical pattern of orthopedic examination of inspection, palpation, range of motion, neurological evaluation, and special tests1. Inspection Check for any visual deformities or abnormal anatomical alignments in the coronal and sagittal plane including typi ..read more
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Neck Pain Causes and Treatments
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Written by Katherine Esser and Dr. Nabil Ebraheim Neck pain is a common ailment of the American population, affecting 30 to 50% of adults annually. While there are numerous etiologies of neck pain, this is a brief review of the more common causes and modes of treatment. Firstly, radiculopathy from disc herniation. In addition to neck pain, the patient will complain of arm pain that typically follows a myotomal pattern, and sensory symptoms (like burning and tingling) that follow a specific dermatome in the hand. There may also be motor weakness of the upper extremity. This is due to compressio ..read more
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ACL Ganglion Cyst, Meniscal Cyst, Baker Cyst — Everything You Need to Know
Dr. Nabil Ebraheim's Blog – Ohio Orthopedic Surgeon
by Dr. Nabil Ebraheim
2y ago
Written by Ali Mahmoud with Dr. Nabil Ebraheim  There are many cysts that can occur in and around the knee joint. These types of cysts include an anterior cruciate ligament (ACL) ganglion cyst, meniscal cyst, and baker’s cyst. Ganglion cysts contain yellow viscous fluid surrounded by a thin capsule, and are considered rare when associated with the ACL (1). Theorized pathogenesis of an ACL ganglion cyst includes synovial tissue herniation, post-traumatic mucoid degeneration mediated by local release of hyaluronic acid, ectopic synovial tissue theory, and displacement of synovial fluid ..read more
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