A 22-year-old male presents to clinic with complaints of right shoulder pain ongoing for about 3 weeks. He states he has been going to the gym more frequently to become more fit. He says the pain is intermittent and is worse with deep breathes. He describes the pain as sharp and rates the pain a 5/10 at worst. No alleviating nor aggravating factors are identified on further questioning. Osteopathic structural examination reveals decreased restriction of movement on exhalation of ribs 7-10 on the right. Which of the following nerves innervates the muscle that osteopathic treatment should be focused towards?

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May 29, 2023 No Comments

A 70-year-old female with past medical history of dementia presents to clinic with her daughter after recent fall. The daughter explains that ever since her mother’s most recent fall, she has been walking with a limp. Physical examination is significant for an antalgic gait. Xray images taken in the office demonstrate intact osseous structures of the pelvis and lower extremities. Osteopathic structural examination reveals the left transverse process of L5 to be deeper than that of the right. The rotational asymmetry appears to become more symmetric as the patient bends forward. Given the exam findings above, which of the following is a possible somatic dysfunction exhibited by the sacrum?

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May 29, 2023 No Comments

A 70-year-old female with past medical history of dementia presents to clinic with her daughter after recent fall. The daughter explains that ever since her mother’s most recent fall, she has been walking with a limp. Physical examination is significant for an antalgic gait. Xray images taken in the office demonstrate intact osseous structures of the pelvis and lower extremities. Osteopathic structural examination reveals a positive seated flexion test on the left. The patient also has a deeper sacral sulcus on the left and a shallower sacral sulcus on the right. Given the exam findings above, which of the following is a possible somatic dysfunction exhibited by L5?

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May 29, 2023 No Comments

A 19-year-old male presents to the clinic with complaints of low back pain ongoing for 2 weeks. He recently had a skateboarding accident where he fractured his right radius. He states that he has run out of the opioid pain medication given to him by the Emergency Department and that he had not noticed the back pain until now. While the patient is seated, the posterior superior iliac spines are palpated bilaterally. The patient is asked to bend forward as if to touch his toes. The right and left posterior superior iliac spines move at the same time and to the same distance. A lumbosacral spring test is found to be positive. Given the exam findings, which of the following is the most likely diagnosis of the patient’s sacral somatic dysfunction?

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May 29, 2023 No Comments

A 19-year-old male presents to the clinic with complaints of low back pain ongoing for 2 weeks. He recently had a skateboarding accident where he fractured his right radius. He states that he has run out of the opioid pain medication given to him by the Emergency Department and that he had not noticed the back pain until now. Osteopathic structural examination reveals a positive seated flexion test on the left. His left sacral sulcus is found to be shallower than the right and his left ILA is also found to be shallower than the right. Given the exam findings, which of the following is the most likely diagnosis of the patient’s sacral somatic dysfunction?

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May 29, 2023 No Comments

A 28-year-old female presents to clinic with complaints of bilateral hip pain. She states that she had recently given birth to her second child 2 weeks ago. She opted to give birth via spontaneous vaginal delivery. However, since the event, she has had pain in her hips when she walks. Osteopathic structural examination reveals a positive seated flexion test on the left. Palpation of the sacrum reveals the left sacral sulcus to be shallower than the right and ILA to be deeper on the left. Given the exam findings, which of the following is the most likely diagnosis of the patient’s sacral somatic dysfunction?

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May 29, 2023 No Comments

A 28-year-old female presents to clinic with complaints of bilateral hip pain. She states that she recently had gave birth to her second child 2 weeks ago. She opted to give birth via spontaneous vaginal delivery. However, since the event, she has had pain in her hips when she walks. Osteopathic structural examination reveals a positive seated flexion test on the left. Palpation of the sacrum reveals a deeper left ILA and sacral sulcus. Given the exam findings, which of the following is the most likely diagnosis of the patient’s sacral somatic dysfunction?

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May 29, 2023 No Comments

A 68-year-old male presents to clinic with complaints of low back pain for 4 days. The patient states that the pain started after moving around some heavy boxes in his garage. He denies any radicular symptoms or radiating pain. His past surgical history includes an open reduction and internal fixation of his right femur 2 years ago. His vital signs are currently within normal limits. Physical examination is significant for mild tenderness to palpation of the lumbar paraspinal musculature bilaterally. Osteopathic structural examination reveals a positive seated flexion test on the right as well as a positive sphinx test. Given the exam findings above, which of the following is a possible somatic dysfunction exhibited by L5?

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May 29, 2023 No Comments

A 68-year-old male presents to clinic with complaints of low back pain for 4 days. The patient states that the pain started after moving around some heavy boxes in his garage. He denies any radicular symptoms or radiating pain. His past surgical history includes an open reduction and internal fixation of his right femur 2 years ago. His vital signs are currently within normal limits. Physical examination is significant for mild tenderness to palpation of the lumbar paraspinal musculature bilaterally. Osteopathic structural examination reveals a positive seated flexion test on the right. Palpation of the right sacral sulcus is more anterior than the left and the left ILA is more posterior than the right. Given the exam findings above, which of the following is the most likely somatic dysfunction exhibited by L5?

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May 29, 2023 No Comments

A 71-year-old female presents to clinic with complaints of right sided hip pain for 2 weeks. She denies trauma and says the pain began after playing with her grandchildren. She has tried over-the-counter medications without relief of her symptoms. Osteopathic structural examination reveals a sacral somatic dysfunction of a left rotation on left oblique axis (“left-on-left”) torsion. Which of the following sets of physical exam findings would be most consistent with the diagnosis?

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May 29, 2023 No Comments