CONTACTS
SUBJECTS
MRI Right Foot Injury Pain Plantar Plate Tear Metatarsalgia Radiolog
1803 -
1803 - ..
1804 - Summary/Objective
1805 -
180501 - Follow up ref SDS A6 0000. ref SDS 98 0000.
180502 -
180503 -
180504 -
180505 -
180506 -
180508 - ..
1806 -
1807 -
1808 - Background
1809 -
180901 - Meeting Doctor Tang in Podiatry on 140805 1030. ref SDS 36 NU4G
180902 - Progress Notes for meeting on 140805, call for return to clinic after
180903 - receiving FFO. ref SDS 36 IJ4G A few days after meeting on 140805,
180904 - received letter from VA scheduling follow meeting today on 140820
180905 - 1000.
180907 - ..
180908 - On 140828 meeting with Doctor Kevin Daun and later with Doctor Mihara,
180909 - attending developed solution to blister on inside of big toe on left
180910 - foot, ref SDS 44 W74O, that required stopping 11 mile hike after 8
180911 - miles and calling for a ride home, shown in case study on 120101 0900.
180912 - ref SDS 9 BO6F
180914 - ..
180915 - On 140904 0900 meeting with Doctor Cynthia Lieu and Doctor Tang,
180916 - attending. ref SDS 47 AK6J Doctor Tang said orthotics can be trimed
180917 - to fit a smaller shoe size, if necessary; he has scheduled a meeting
180918 - after orthotics inserts are received. ref SDS 47 4M3H
180920 - ..
180921 - On 150115 0845 meeting with Doctor Tang and Doctor Goodman, the doctor
180922 - ordered a 2nd set of orthotic inserts to recover from and prevent
180923 - recurrance of metatarsalgia. ref SDS 52 BG6I
180925 - ..
180926 - On 151215, met with Doctor Hewitson in Podiary. ref SDS 58 AK6J He
180927 - modified the Prolab orthotic inserts applied with Hoka Stinson Lite
180928 - shoes size 10 worn today, and for the purpose of improving routine
180929 - walking gait. ref SDS 58 9B6I Observation of walking tests, and
180930 - placing the doctor's hands on the patient's hips while standing to
180931 - evaluate body alignment, indicated to Doctor Hewitson that this
180932 - initial modification did not correct defect in walking gait, so he
180933 - removed that modification and instead raised the heel of the left
180934 - orthotic. ref SDS 58 NC7M
180936 - ..
180937 - Doctor Hewitson said to bring in the other pair of orthotic inserts on
180938 - the next meeting in Podiatry for adding modifications that make both
180939 - pair the same. ref SDS 58 1J98
180941 - ..
180942 - On 151215 1000 Progress Notes explain modifications to orthotics -
180943 - Improved gait by decreasing early heel off L, increased L knee
180944 - extension, and decreased R recurvatum. ref SDS 59 ZA9I
180946 - ..
180947 - On 151215, Doctor Hewitson and his team made molds of the feet to make
180948 - new orthodic inserts. They will be shipped in a few weeks. When new
180949 - orthotics are received, notify VA to schedule follow with Doctor
180950 - Hewitson to review effectiveness, and to make modifications as needed,
180951 - and as done on 151215.
180953 - ..
180954 - On 151215 1000 Progress Notes confirm follow up meeting will occur
180955 - after receiving orthotic inserts. ref SDS 59 PK6L
180957 - ..
180958 - On 140101 0600 case study reporting on 151222, developed new blister
180959 - on left side little toe left foot, possibly related to changed
180960 - orthotics. ref SDS 15 IE9O
180962 - ..
180963 - On 160202 1540 reported injury to right knee, very painful; Doctor
180964 - Tang recommended not using adjusted orthotic inserts, until meeting
180965 - with Doctor Hewitson in Podiatry Biomechanics can evaluate adjustments
180966 - to avoid right knee injury. ref SDS 66 WG59
180968 - ..
180969 - On 160325 0443 letter to VA notifies Doctor Tang that orthotic inserts
180970 - ordered by Doctor Hewitson on 151215, have been received, so meeting
180971 - can be scheduled for Doctor Hewitson to configure the new inserts,
180972 - ref SDS 67 AK6J, as planned by the doctor during the prior meeting on
180973 - 151215. ref SDS 58 HM8J
180975 - ..
180976 - On 160503 1130 encountered Doctor Hewitson in the cafeteria; he agreed
180977 - to provide care after lunch at 1300 in Podiatry. 160503 1256,
180978 - ref SDS 70 9A34
180980 - ..
180981 - On 160503 1300 meeting Doctor Hewitson in Podiatry. Since this
180982 - meeting was ad hoc, we did not have the 3 sets of orthotic inserts
180983 - which he planned to modify, shown in the record on 151215 1000.
180984 - ref SDS 58 1J98 Scheduled another meeting on 160516, for Doctor
180985 - Hewitson to improve alignment of ankles, knees and hips. 160503 1256,
180986 - ref SDS 70 TN94
180988 - ..
180989 - On 161212 meeting with Doctor Alexis Dang in Orthopedics, the doctor
180990 - recommended review by Podiatry to correct Tailor's Bunion. ref SDS 74
180991 - OG4N
180993 - ..
180994 - On 161219 2208 wrote letter to Doctor Tang and Doctor Hewitson,
180995 - ref SDS 76 V13J, requesting care for Tailor's Bunion, ref SDS 76 X659,
180996 - and prescription for liquid Naproxen. ref SDS 76 X65V
180998 - ..
180999 - On 161220 0927 Doctor Tang offered prescription for diclofenac gel to
181000 - replace Naproxen to control inflammaton to feet and joints from
181001 - hiking. ref SDS 77 0657 Letter to Doctor Tang requested prescription.
181002 - ref SDS 77 J99T The doctor notified that he ordered diclofenac gel,
181003 - and can pick it up at Pharmacy today. ref SDS 77 L668
181005 - ..
181006 - On 161221 0730 xray both feet evaluate Tailor's Bunion, and other
181007 - injuries to feet. ref SDS 78 JT6G
181009 - ..
181010 - On 161221 0822 received prescription from VAMCSF Pharmacy for
181011 - diclofenac gel to replace Naproxen to control inflammation during
181012 - hikes. ref SDS 79 Z38F
181014 - ..
181015 - On 161222 1519 Doctor Tang called and reported xray found no evidence
181016 - of Tailor's Bunion, nor other severe injury to feet. ref SDS 82 HQ5O
181018 - ..
181019 - On 170315 1146 submitted letter to Doctor Tang in Podiatry, thanking
181020 - the VA for timely care, and asking for the name of the treatment that
181021 - may be offered in clinical trial for metatarsalgia. ref SDS 89 F64G
181023 - ..
181024 - On 170317 0847 letter to Gina who gave Supartz injections, ending on
181025 - 170206, and requesting meeting for few minutes, ref SDS 90 H84K, also,
181026 - called and left message for Gina on meeting, purpose is to request
181027 - assistance expediting meeting on Supartz treatment for metatarsalgia.
181028 - ref SDS 90 F97H
181030 - ..
181031 - On 170318 1113 received call from Moses in VA Orthopedics; scheduled
181032 - meeting with Doctor Thuillier to consider treatment in clinical trial
181033 - for using Supartz in right foot. ref SDS 91 HQ5O
181035 - ..
181036 - On 170327 1430 meeting with Doctor Dan Thuillier in Orthopedics,
181037 - ref SDS 92 HQ5O; doctor advised VA does not support clinical trial
181038 - applying Supartz for metatarsalgia. ref SDS 92 D33N; Doctor Thuillier
181039 - explained shoes with stiffer forefoot, like Hoka Stinson 3, help
181040 - prevent metatarsalgia injuries. ref SDS 92 W44I Doctor Thuillier
181041 - diagnosed possible plantar plate tear, ref SDS 92 I54I, and
181042 - demonstrated Plantarflexion taping to prevent further injury during
181043 - hiking, and he submitted a letter with a video showing procedure for
181044 - plantarflexion taping. ref SDS 92 774N
181046 - ..
181047 - On 170412 0800 prior MRI study on both feet. ref SDS 98 0001
181049 - ..
181050 - On 171227 0915 meeting with Doctor Thuillier in Orthopedics, 171227
181051 - 0915. ref SDS A4 PO8I During the meeting the doctor ordered MRI
181052 - studies on both feet and both knees to evaluate results of PRP
181053 - treatment. ref SDS A4 E54H
181055 - ..
181056 - On 171229 0745 MRI right knee regenerate cartelage compare left knee.
181057 - ref SDS A5 K05I
181059 - ..
181060 - On 171229 0900 MRI both feet evaluate PRP treatments. 171229 0900,
181061 - ref SDS A6 HQ5O
181062 -
181063 -
181064 -
181066 - ..
1811 -
1812 -
1813 - Progress
1814 -
181401 - Prior MRI study on both feet reported on 170412 0800. ref SDS 98 0001
181402 - Most recent MRI on both feet and both knees was on 171229 0900.
181403 - ref SDS A6 HQ5O
181405 - ..
181406 - Radiology study today was ordered by Doctor Edwards, in a letter from
181407 - Jane in Orthopedics, received yesterday on 190326 1713. ref SDS A8
181408 - V54H
181410 - ..
181411 - This follows up letter to Gina a few days ago presenting scope of
181412 - issues for the doctor to review, which included shoulders and elbows.
181413 - reported on 190325 0936. ref SDS A7 MB75
181415 - ..
181416 - Arrived at Radiology checkin.
181418 - ..
181419 - Xrays took about 20 minutes.
181420 -
181422 - ..
181423 - Radiologist report is stored in...
181424 -
181425 - F:\05\00003\SM\CC\AGMJ\20190327-091500\W0144.pdf
181426 -
181427 -
181428 - ELBOW,RIGHT,3 OR MORE VIEWS
181429 - Exm Date: MAR 27, 2019@07:35
181430 - Req Phys: ROBERTSON,BRIAN Pat Loc: ORTHO-THUILLIER (Req'g Loc)
181431 - Img Loc: RADIOLOGY*
181432 - Service: Unknown
181433 -
181434 - (Case 662-032719-697 COMPLETE) ELBOW,RIGHT,3 OR MORE VIEWS
181435 - (RAD Detailed)
181436 - CPT:73080
181438 - ..
181439 - Reason for Study: Rt elbow pain
181440 - Clinical History:
181441 - 3V elbow
181442 - Report Status: Verified Date Reported: MAR 27, 2019
181443 - Date Verified: MAR 27, 2019
181444 - Verifier E-Sig:/ES/RAMYA SRINIVASAN, MD
181446 - ..
181447 - Report:
181448 - X-RAY EXAM OF right ELBOW
181449 -
181450 - CLINICAL HISTORY: Rt elbow pain, no further history provided
181451 -
181452 - COMPARISON: None
181454 - ..
181455 - Impression:
181456 -
181457 - No evidence of acute fracture or dislocation. Joint spaces
181458 - and alignment are maintained. Olecranon enthesopathy.
181460 - ..
181461 - The images were personally reviewed by Ramya Srinivasan MD
181462 - who agrees with the above interpretation.
181463 -
181465 - ..
181466 - Primary Diagnostic Code:
181468 - ..
181469 - Primary Interpreting Staff:
181470 - RAMYA SRINIVASAN, MD, ATTENDING RADIOLOGIST (Verifier)
181471 - Primary Interpreting Resident:
181472 - DYLAN T CREBS, MD, RESIDENT-RADIOLOGY
181473 - /DTC
181474 -
181475 -
181476 -
181478 - ..
181479 - KNEE ORTHO OA, BILAT: ROSENBERG, STANDING AP, LAT, MERCHANT
181481 - ..
181482 - Exm Date: MAR 27, 2019@07:35
181483 - Req Phys: ROBERTSON,BRIAN Pat Loc: ORTHO-THUILLIER (Req'g Loc)
181484 - Img Loc: RADIOLOGY*
181485 - Service: Unknown
181486 -
181487 - (Case 662-032719-698 COMPLETE) KNEE ORTHO OA, BILAT: ROSENBERG, (RAD Detailed)
181488 - CPT:73565
181489 -
181490 - Reason for Study: Bilat knee pain
181491 - Clinical History:
181492 - Report Status: Verified Date Reported: MAR 27, 2019
181493 - Date Verified: MAR 27, 2019
181495 - ..
181496 - Verifier E-Sig:/ES/RAMYA SRINIVASAN, MD
181498 - ..
181499 - Report:
181500 -
181501 - X-RAY EXAM OF KNEES
181502 -
181503 - CLINICAL HISTORY: Bilat knee pain
181504 -
181505 - COMPARISON: Bilateral knee radiographs 12/16/2015
181507 - ..
181508 - Impression:
181510 - ..
181511 - Right knee: Medial femorotibial joint space narrowing with
181512 - tricompartmental osteophytes compatible with
181513 - osteoarthritis, progressed from prior. Some articular
181514 - depression at the medial femoral condyle may be the result
181515 - of prior insufficiency fracture. Heterotopic ossifications
181516 - along the medial joint line likely related to prior MCL
181517 - injury. Small joint effusion.
181519 - ..
181520 - MCL was injured twice in 2016
181522 - ..
181523 - xray report continues...
181524 -
181525 - Left knee: Medial and lateral femorotibial joint space
181526 - narrowing with tricompartmental osteophytes compatible
181527 - with osteoarthritis, progressed from prior. Small joint
181528 - effusion.
181530 - ..
181531 - This compares with findings from xray on 151216 1130. ref SDS 60 BO5O
181532 -
181533 - The left knee shows moderate medial compartmental and
181534 - medial patellofemoral joint space narrowing and moderate
181535 - tricompartmental marginal osteophytes.
181537 - ..
181538 - Seems to be stable since xray on 151216, indicating PRP treatments
181539 - enabled hiking Half Dome and 3,500 miles last year.
181541 - ..
181542 - Xray on 190327 continues...
181543 -
181544 - The images were personally reviewed by Ramya Srinivasan MD
181545 - who agrees with the above interpretation.
181547 - ..
181548 - Primary Diagnostic Code:
181550 - ..
181551 - Primary Interpreting Staff:
181552 - RAMYA SRINIVASAN, MD, ATTENDING RADIOLOGIST (Verifier)
181553 - Primary Interpreting Resident:
181554 - DYLAN T CREBS, MD, RESIDENT-RADIOLOGY
181555 - /DTC
181556 -
181557 -
181558 -
181559 -
181560 -
181561 -
1816 -