Maria M.

Main

Septa Accident

3/5/09

Passenger on Septa Bus, bus quickly slammed on brakes and she was thrown forward and hit her back against the metal pole, twisted her left knee and her left ankle.

Jurisdictional

Objective

MRI of L. Knee

3/7/09

Chondromalacia patella at the left knee. Benign appearing bone cyst proximal lateral tibia.

MRI of L. Ankle

3/7/09

Minimal medial soft tissue swelling

MRI Lumbar Spine (See Cottman)

3/7/09

Shallow eccentric disc herniation to the left at L4-5 and to a lesser degree at L5-S1 with some disc bulging to the left but without distinct evidence of focal disc hernaition.

EMG (See Cottman)

7/10/09

Mild to Moderate L4-5 radiculopathy on the left

MRI of Lumbar Spine (See Cottman)

5/5/11

Left foraminal disc protrusions at L3-4 and L4-5 causing left sided foraminal stenosis and mild compromise of the exiting nerve roots at these levels. Fluid collection in the superficial operative bed at the L4-5 level.

Treatment

Mary Ann Colvin (PCP)

2009 - 2012

Routine care

John Maher (Chiro)

2/7/2009 - 12/4/2010

Chiropractor for back

John Bowden Jr.

4/2009 - 11/30/2010

Physical therapy, heat, tens unit on back/knee/ankle and exercises. Performed MRI of lumbar, knee, and ankle (March 6, 2009) and EMG of back (June 30, 2009).

Mark Davart (Ortho)

5/2009 - 11/18/2010

For back and knee. He gave her injections of her left knee, trigger point injections for back, and epidural/nerve root injections for back. Also performed the orthoscopic surgery of the left knee

Physical Examination: Dr. Bowden (Cottman)

10/28/2009

Antalgic Gait, positive SLR, crepitus bilaterally in her knees, marked tenderness over lower back area paravertabral musculature, loss of motion in ankle. Weight is 290 lbs.

Progress Note: Dr. Bowden (Cottman)

1/19/10

Reported pain at 0/10, with some exertion to 3/10. Returned to work on January 4, 2010.

Physical Exam: Dr. Avart (Post Knee Surgery)

4/1/2010

Left knee peripatellar pain, mild swelling, synovitis, clicking and crepitus and pain on extremes of motion. Weakness in the quads and hamstrings with mild atrophy distally and poor push off. Lower lumbar tenderness, painful spasm, and pain on extremes of flexion and extension clinically. Injected knee with cortisone and Xylocaine. Recommended Pain management.

Surgery of L. Knee (See Cottman)

9/22/10

Performed by Dr. Davart

Jay M. Mergaman, M.D. (Pain Management)

12/2/10 - 2/9/12

Leonard A. Bruno (Neurosurgery)

1/2011

Performed MRI and Emergency Surgery

Inpatient Holy Redeemer Hospital

1/10/11 - 1/15/11

Went to ER on 1/3/11 for pain, they sent her home calling it "bad sciatica", she then returned on the 10th and an MRI was performed and Dr. Bruno wanted to perform surgery due to herniated disc that was split in two.

Back Surgery for herniated disc

1/13/11

Physical Exam w/Dr. Bowden (Cottman)

4/26/11

Examination reveals noted bilateral pain of the paravertabral musculature and corresponding interspinious ligaments. Spasm noted adjacent to her surgical scar. And also spasm to the sacroiliac articulation, flexion 60/90. Bilateral sitting root test noted.

Opinion

AOD

2/5/2009

SGA

3/15/2010