Misinterpretation of regional sensory loss in an injured worker: a case report.
Regional patterns of motor or sensory loss are considered indicators of a behavioral component to the complaints of an injured worker. This assumption may lead to a discounting of signs and symptoms with premature return to work and discharge from care. We present the case of a 25-year-old airline baggage handler with an 8-month history of unresolved neck and shoulder complaints who had been returned to work after a lack of objective findings on physical examination. On physiatric evaluation, his unusual pattern of insensitivity to pinprick led to prompt magnetic resonance imaging that revealed a focus of increased intramedullary signal at C6 consistent with a syrinx. This case report shows the importance of a detailed neuromuscular examination coupled with appropriate diagnostic imaging in the assessment of individuals with regional sensory or motor loss so as not to miss more serious spinal cord pathology.
Nadler
Scott F
SF
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA. sfnadler@cs.com
Andrus
Stephen G
SG
Malanga
Gerard A
GA
Stitik
Todd P
TP
D000328:Adult; D000401:Aircraft; D002574:Cervical Vertebrae / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology; D009784:Occupational Diseases / Q000175:diagnosis*; D012678:Sensation Disorders / Q000175:diagnosis / Q000209:etiology*; D020069:Shoulder Pain / Q000209:etiology; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis*