White Male with Hip Pain (1)

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Phoenix College *

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160

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Medicine

Date

Oct 30, 2023

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docx

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Uploaded by ChefExplorationWhale32

1 White Male with Hip Pain In the case of the 43-year-old male presenting with chronic pain and a complex medical history, the primary diagnosis is Complex Regional Pain Disorder (CRPD), also known as Reflex Sympathetic Dystrophy (RSD). The patient has been experiencing severe pain and symptoms for several years, but his condition has been met with skepticism by some healthcare providers, leading to a referral to psychiatry. Three key decisions were taken for this patient: The first decision entailed administering Neurontin to manage pain after assessing and diagnosing the patient's condition. The diagnosis of CRPD/RSD is based on the constellation of symptoms, including severe pain, cramping, color changes in the affected leg, and a history of traumatic injury. This diagnosis is supported by the patient's clinical presentation, as well as electromyogram (EMG) findings. The second decision was to drop Neurontin and replace with Zoloft. While the case did not specify the treatment plan, the patient reported that his family doctor had prescribed hydrocodone for pain management. The goal of this decision was to alleviate the patient's suffering and provide relief from his symptoms. The third decision was to add Bupropion to the treatment. The patient's psychiatric referral based on the belief that the condition is purely psychogenic is a significant concern. The decision was to address the misconception that CRPD/RSD is solely a result of depression. This is vital in providing appropriate care and addressing the patient's concerns. The decisions taken in this case are generally in line with evidence-based practices for diagnosing and managing CRPD/RSD. Complex regional pain disorders like CRPD are complex and require a multidisciplinary approach, including physical therapy, analgesic medications, and

2 interventions like sympathetic nerve blocks (del Piñal, 2022).. While the specific treatment was not detailed in the case, pain management strategies are well-established in the literature. The primary goal of these decisions was to achieve a proper diagnosis, initiate pain management to alleviate the patient's suffering, and address the misconceptions that led to the psychiatric referral (Habenicht, 2023). By doing so, the patient can receive the appropriate care and support he needs for his complex pain disorder. The case study did not specify the results of the decisions or the treatment's outcomes. However, in a real clinical scenario, it is expected that the patient would experience some relief from his symptoms with appropriate pain management and that his understanding of the condition would improve, reducing any related psychological distress.

3 References del Piñal, F. (2022). Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients. Plastic and Reconstructive Surgery 150(1):p 93-101, | DOI: 10.1097/PRS.0000000000009243 Habenicht, A. L. (2023). Resolution of Stridor, Gastritis and Cephalgia in an Adolescent with Reflex Sympathetic Dystrophy Following Osteopathic Manipulative Treatment—A Case Report. The AAO Journal , 33 (3), 14–20. https://doi.org/10.53702/i2375-5717-33.3.14

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