Part I     Back Injuries, Fibromyalgia and RSD

Injuries of the Back - Herniated Intervertebral Disc

Definitions for disc abnormalities are not consistent between the fields of radiology, orthopedics and neurosurgery. Definitions also vary within the field of radiology. The following definitions are most often utilized by radiologists:
 
Disc Bulge - an extension of the disc wall (annulus fibrosus) beyond the boundary of the adjacent vertebral end plates. A disc bulge occurs around the entire circumference of the disc but some radiologists will describe it also at a focal point such as central or posterior in location. The disc wall remains in tact and the nucleus pulposus does not move. This is usually degenerative and not pathological or cause nerve impingement.
 
Disc Herniation - a greater extension of the disc wall associated with some degree of defect or tear in the disc wall and movement of the nucleus pulposus.
 
Herniated Nucleus Pulposus (HNP)/Disc Protrusion - a focal extension of nucleus pulposus through a tear in the disc wall which can result in displacement of epidural fat, the thecal sac, the spinal cord or a nerve root. Some radiologists define a disc protrusion as a tear in the disc wall with or without movement of nucleus pulposus outside the wall.
 
Extruded Herniated Disc/Disc Extrusion - extension of nucleus pulposus through a complete tear of the disc wall. The nucleus pulposus remains attached to its origin.
 
Sequestered Herniated Disc - a free fragment of nucleus pulposus.

Treatment - Soft Tissue

PENS - Precutaneous Electrical Nerve Stimulation - Electrical signals are passed through thin needle-like electrodes which are inserted in soft tissue or muscle.
 
Iontophoresis (ion transfer) - is the introduction of ions or medicated lotions into the skin using direct current.

Treatment - Herniated Intravertebral Discs

IDET - Intravertebral Disc Electrical Therapy or Treatment. A needle is directed into the disc under the guidance of flouroscopy (moving X-Ray). A wire, called a catheter, is inserted through the needle into and around the inner part of the disc wall. The wire is heated and tightens the loose protein molecules. It is felt IDET can sooth damaged nerve endings and can cause loose ligaments to contract, in effect resealing the herniated disc and making it more firm.

Part II     Injuries of the Extremities

Sprains, Strains & Fractures - Fracture complications

Phlebitis, an inflammation of the vein, can occur as a result of tissue damage or immobility of an extremity. This can lead to Deep Vein Thrombosis (DVT) with the formation of blood clots within the blood vessel. If a blood clot enters the blood flow it can become filtered in the lungs. This is termed a Pulmonary Emboli and results in respiratory distress. These conditions more commonly occur in the lower immobilized extremities.

Injuries of the Shoulder - Dislocated Shoulders

A SLAP (Superior Labrum, Anterior to Posterior) Lesion is a tear to the glenoid labrum above the middle of the glenoid socket and can also involve the biceps tendon.
 
A Bankart Lesion is a tear to the glenoid labrum below the middle of the glenoid socket and also involves the inferior glenohumeral ligament. Glenoid labrum tears indicate a significant injury to the glenohumeral joint capsule.

Injuries of the Shoulder - Impingement syndrome

Examination Findings
 
Pain specific to the area beneath the acromion.
 
The Impingement Sign is positive when pain is experienced during abduction (movement of the extremity away from the body) while the examiner applies resistance or downward pressure to the arm.

Part III     Closed Head Injuries, Psychological Claims and TMJ