Re: pubic bone pain
From: Richard Chudacoff, MD (rchudacoff@mylinuxisp.com)
Mon May 17 15:19:16 2004
Nuclear scan us unclear, so we go for the MRI
--
Richard Chudacoff, MD
Every man is the son of his own works.
Miguel de Cervantes
-----Original Message-----
From: Nancy Willis-Smith [mailto:NancyFNP@seqw.com]
Sent: Wednesday, May 12, 2004 10:01 PM
To: rchudacoff@mylinuxisp.com
Subject: Re: pubic bone pain
Did you find out anything on this patient?
Nancy
>----- Original Message -----
From: "Richard Chudacoff, MD" <rchudacoff@mylinuxisp.com>
To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net>
Sent: Friday, May 07, 2004 12:08 PM
Subject: Re: pubic bone pain
> FYI, an astute NP on our list recommended a bone scan, and my radiologist
> agreed with this as the first choice of diagnostic studies. The NP was too
> shy to post this to the list, feeling that we do not appreciated
> non-physician input. I disagree.
>
> Richard Chudacoff, MD
>
> Liberty will not descend to a people;
> a people must raise themselves to liberty;
> it is a blessing that must be earned before it can be enjoyed.
>
> Charles Caleb Colton
>
> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne
> Bulley, MD
> Sent: Friday, May 07, 2004 11:52 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: Re: pubic bone pain
>
> I agree - In addition, with the younger patients in whom I identify pain
> on palpation of the symphysis or pubic rami or other boney elements, I
> usually start the patient on maximal doses of NSAID's while getting the
> imaging and getting the conosults with Ortho and / or PT. Usually the
> complaints seem to stem from birth events.
>
> With some one at this patient's age I would do the imaging without the
> NSAID's. I would *assume* that some process is happening to cause this.
>
> Joanne
>
> At Fri, 7 May 2004, art fougner, md wrote:
> >
> >Rich -
> >
> >CT better for bone - MRI for muscle and soft tissue. Also, consider
> >neuro consult in addition to orthopod.
> >
> >another example of the frustrations of dealing with chronic pain -
> >frustrating for patient, frustrating for practitioner.
> >
> >At Thu, 6 May 2004, Richard Chudacoff, MD wrote:
> >>
> >>Would an MRI be better? It did not feel as if she had a diathesis. No
> other
> >>co-morbidities like diabetes, and she does not believe she had a Burch
or
> >>MMK with her hysterectomy, which was done for cervical dysplasia
> >>
> >>--
> >>Richard Chudacoff, MD
> >>
> >>Liberty will not descend to a people;
> >>a people must raise themselves to liberty;
> >>it is a blessing that must be earned before it can be enjoyed.
> >>
> >>Charles Caleb Colton
> >>
> >>-----Original Message-----
> >>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> >>RModugno@aol.com
> >>Sent: Thursday, May 06, 2004 4:26 PM
> >>To: Multiple recipients of list OB-GYN-L
> >>Subject: Re: pubic bone pain
> >>
> >>In a message dated 5/6/2004 4:39:51 PM Eastern Daylight Time,
> >>rchudacoff@mylinuxisp.com writes:
> >>
> >>> My impression is that she probably has either periosteal inflammation
or
> >>infection, or osteitis. My problem is I don't have anything in any of
my
> >>textbooks on which way to proceed. Can anybody give me some helpful
> >>pointers, or should I
> >>> transfer her to an orthopedist?
> >>>
> >>> Richard Chudacoff, MD, FACOG
> >>
> >>Xray symphysis?
> >>
> >>Robert Modugno MD MBA FACOG
> >>Marietta, GA
> >>http://www.novaobgyn.yourmd.com
> >>
> >--
> >art fougner, md
> >ich bin ein New Yorker
> >
>
> --
> Joanne Bulley, MD
> Keene, NH, USA
>
> -----
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>
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