Dear all,
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I was hoping to pick some of your brains,
I saw a patient in clinic today and have been unable to forget about them, 50 year old man, with previous hisotry of a fibula fracture in the affected limb History of asthema and a smoker. Bascially their clinical presentation was uni-lateral distal muscle atrophy in the gastroc-soleus complex, with fasiculations and localised hypotonia. The limb is apart from what i described otherwise healthy in comparison to the other, same hair growth, healthy skin, etc.
Patient was offered steriod injections to stop the the pain accompanied down the route of the common peroneal nerve. I will be seeing patient again in a week for a full biomechanical and neurolgical examination, (more neurolgical) From my perspective i feel all that can be done is to refer on to their g.p reporting my findings and suggest the futher course of action to him,
To me my first thoughts have been CPRS (hhowever i found this problem pre-dated the fibula fracture he suffered) Nerve root compression, or at least an entrapped nerve, or more worringly a LMN,
Any of your thoughts would be appreciated
Chris
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