title: Misinterpretation of regional sensory loss in an injured worker: a case report.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA. sfnadler@cs.com
authors.forename: Scott F
authors.initials: SF
authors.lastname: Nadler
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Andrus
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Malanga
authors.forename: Todd P
authors.initials: TP
authors.lastname: Stitik
mesh_terms: 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*