Overlooked physical diagnoses in chronic pain patients involved in litigation.

This study followed the course of 60 chronic pain patients, from referral to a pain diagnostic center through the formulation of complete discharge diagnoses. The most common referral "diagnoses" were really descriptions or vague explanations, such as "chronic pain," "psychogenic pain," "cervical strain," or "lumbar strain." The most commonly missed diagnoses were 1) myofascial disease, 2) facet disease, 3) peripheral nerve entrapment, 4) radiculopathy, and 5) thoracic outlet syndrome.

Quantification of thermal asymmetry. Part 1: Normal values and reproducibility.

The use of thermography in evaluating nerve injury is based on the presence of temperature asymmetries between the involved area of innervation and the corresponding area on the opposite side of the body. However, interpretation of the thermographic image has been troubled by subjectivity. This paper describes a computer-calculated method of collecting data that eliminates subjective biases.

Quantification of thermal asymmetry. Part 2: Application in low-back pain and sciatica.

Temperature differences between the lower extremities were measured using a computerized thermometric scanning system in order to compare the degree of thermal asymmetry in 144 patients with low-back pain. The patients displayed highly significant thermal asymmetries, with the involved limb being cooler (p less than 0.001).