1. Orthopedics and Neurology Case Presentation Whiplash Type Injury
James J. Lehman, DC, MBA, DABCO
University of Bridgeport College of Chiropractic

2. Lab Assignment Listen to history and report of findings Take notes
Answer questions
Write SOAP notes for this patient

3. Whiplash Type Injury 32 year-old female Driver Rear-ended one-year ago
Good health
No prior injuries
2 children (4 & 7 Y/O)

4. Symptomotology Neck pain Headaches Weak neck Tingling in fingers
Insomnia

5. History Closed-ended Open-ended OPQRST ADL Police report
Medical records

6. Activities of Daily Living
Work
Childcare
Marital relations
Exercise

7. Objective Findings
Reduced CAROM, PROM, and RROM with extension, RLF, and RROT with pain at C

8. Sensory Findings
Hypesthesia (pain with pin prick and light touch with wisp of cotton)bilaterally at thumb, index, third finger

9. Motor Findings Biceps, wrist extension and flexion 4/5 bilaterally
Remainder of brachial plexus 5/5 bilaterally
Grip strength reduced bilaterally

10. Deep Tendon Reflexes
All upper and lower extremity DTR’s are 2+ bilaterally and brisk except brachioradialis
1+ right
2+ sluggish left

11. Pathologic Reflexes
Absent for signs of Babinski, toe extensor, and Hoffmann’s sign

12. History of Babinski

13. Superficial Abdominal Reflex
Beevor’s Sign absent
Present in all four quadrants

14. Imaging Studies Rule out Fracture Subluxation Dislocation Pathologies
DJD
DDD

15. Radiology Report
What do you think the radiologist diagnosed with this patient from this neutral, lateral view of the cervical spine?
Why?

16. Differential Diagnosis
How to differentiate strain from sprain…

17. Trauma to Cervical Spine
Tearing of disc C5-6-7
What is your DX?

18. Diagnostic Imaging
Diagnostic imaging
Initial
Follow-up