Re: pubic bone pain
From: art fougner, md (evsono@pipeline.com)
Fri May 7 13:06:49 2004
and the results?
art
At Fri, 7 May 2004, Richard Chudacoff, MD wrote:
>
>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
>
>-----
>Mission Accomplished? 5/1/03: major combat operations are over in Iraq. We
>won.
>Mission Unaccomplished. 5/1/04: 131 US troops killed in April 2004 alone.
> 734 total, 596 since "we won".
>"There are no longer torture chambers or rape rooms or mass graves in Iraq."
>
> - GW Bush, 4/30/04
>"U.S. Army report that Iraqi detainees were subjected to "sadistic, blatant
>and
> wanton criminal abuses" at the Abu Ghraib prison near Baghdad."
> - CBS News 4/30/04.
>Torture including rape, sodomization, electrocution, humiliation, dog
>attacks.
> - all photographed by smiling US soldiers.
>
>My duty is to speak. I have no wish to be an accomplice.
>
--
art fougner, md
ich bin ein New Yorker
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