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Fri Apr 21 08:28:20 BST 2006

Had a ununsual case of a 35 year old male who walked into the ER with worsening upper thoracic pain following a judo turnament.  Became worse after throwing an opponent and was associated with rt arm numbness.  Also discribed an unusual sensation when he peed.  Exam revealed symetric reflex, strenght, and sensation.  Rectal exam showed normal feeling and tone.  Pt denied IVDU, fever, and cough.  Spinal X Ray and CBC normal.  Was send home with query mm spain.  He returned with worsening symptoms ( had progressed to lose of strenght in LE bilateral ).  Send for MRI which showed herniated thoracic disc compression on the spine.  With lumbar radiculopathy one waits for lose of str, lose of bowel / bladder function before MRI.  Is it the same for thoracic herniation?  Any ideas on how to pick up these injuries earlier?

  Many Thanks for your insight.

James Heilman 

  It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming.  Theodore Roosevelt

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Thoracic Slipped Disc