u/lagerhaans

I saw this case online as a controversial management decision. Patient reportedly approached surgeon after maximal treatment for Complex Regional Pain Syndrome after undergoing a well-tolerated hip arthroplasty.

This sub doesn’t allow images and out of an M&M mindset, I’m not going to provide links to the surgeon nor site I saw it on/account.
I am a 4th year medical student and I have limited knowledge of CRPS. The images I saw showed a moderately edematous leg with a purplish, kind of livedo patterned skin with minimal hair (although this is a low specificity findings as it is common in the US for women to shave their legs). Also of note, the surgeon posted an exact location of where the pain syndrome region was, about 2 cm proximal to the knee joint. They also showed pre-op radiographs with a stable, uncomplicated artificial hip replacement with no downstream bone pathology.

Patient reportedly tried maximal medical therapy, nerve stimulation, and interventional pain procedures.
The red flags to me are the lack of what the “interventional procedures” and timeline for this arthroplasty were, and the other contributing medical history of this patient. It also strikes me as intriguing that the patient went seeking a very particular treatment for this issue. It might be my naïveté but the hip arthrosplastys I’ve been in on usually leave the region where the patient’s pain is very well alone.

I welcome your discussion, your teaching, and your thoughts on managing such a case. I am reaching out to the broader community to better inform my own opinions regarding this case, as I have many mixed feelings right now.

They can be funny, ridiculous, infuriating, flat wrong, as long as they’re interesting.

I am a medical student, my favorites are:

3. HAGMA (sounds like a Pokémon)

4. NAEON (legitimately a moment of enlightenment while learning to write notes)

5. CHRPE (Lovely to say, lovely for patients to hear it isn’t melanoma)

Inspired by a mentor of mine, and I love to post here about the positive side of medicine as our world burns and Sam Altman becomes the medical board. They have us anonymously write positive things about one another and distribute them so that you know there’s something you bring to your team even at your lowest.

Mine: on my way to see a consult on my sub-I, having been at the hospital for 13 hours, and saw one of my friends in the hallway who laid a man-on-man bear hug on me in the main hallway, told me I looked like I was in my element, and gave me the energy to stop feeling miserable for myself when I was on service doing what I love.

Looking for a piano player (ideally piano performance major undergrad, grad student, or professional)for a reception around Decatur. This is a paid 2.5 hour gig and includes food. Piano is a beautifully tuned Steinway. Show up, tickle the ivories, and enjoy the bar and feast. DM me serious inquiries only.

I am building some extremely niche boxes for a product that is extremely expensive but is used and abused on commission and all of the hardware store and Amazon hinges I’ve used have been utter garbage. The screws are soft, the metal is cheap, and the fit is never tight. Do you all have some brands of small jewelry-esque box hinges that will actually stand up to being put in a bookbag or work bag for years?