Diagnosis

Listening as a Diagnostic Tool in Medicine

Sir William Osler is the physician identified with creating much of our modern medical education system of internship and residency. He would often tell his students something like what I have written above. The goal was to get them to understand that even back at the turn of the 20th century, listening to the patient…read more

What Are CCI Symptoms?

Craniocervical Instability (CCI) is a condition that hasn’t been studied with the same level of detail as many other more common medical diagnoses. Even symptoms are poorly researched. I’d like to change that and my contribution is now the results of the first formal survey of CCI symptoms. Let’s dig in. What Is CCI? CCI…read more

Headaches from Your Neck and Posture

Cervicogenic headaches come from the neck and they can be caused by lots of things. However, some new research this morning shows that a simple issue like posture could be causing quite a few. Let’s dig in. Cervicogenic Headache Cervicogenic headaches start in the neck and are primarily felt in the head. They often follow…read more

Making the Diagnosis of Craniocervical Instability

If you read this blog, you know that I often write about what I experience on a day to day basis. This week I had a telemedicine evaluation with a patient who was scheduled for a C1-C2 screw fixation surgery who didn’t meet our diagnostic criteria for a much less invasive injection-based procedure to treat…read more

Craniocervical Instability Measurements

Did you know that some people have problems with the ligaments that hold their head on? These patients often become like a pinball in the great arcade game of medical specialists, going from one to the other without a diagnosis. They can sometimes find a diagnosis if they meet a doctor who knows which tests…read more

Why Do My Toes Spread Apart When Walking?

On this page: The transverse metatarsal ligament Why toes spread apart when walking A patient with “mushy” forefoot How to treat your feet without surgery The front of your foot is critical for establishing a stable base of support for walking. So what happens when, instead, it’s a mushy mess? For example, if you have…read more

Labrum Tear on Your MRI? It May Not Be Related to Your Hip Pain

Orthopedic surgeons have created yet another mass hysteria in patients over this issue of hip labrum tears. I have spoken with hundreds of patients over the last 5–10 years who are absolutely terrified about a small tear on an MRI image observed by a radiologist after they developed hip pain. While surgery is often recommended,…read more

Getting the Right MRI: What Your Doctor Won’t Tell You

One thing that surprises patients is that there can be huge differences in the quality of MRIs. I experienced this yesterday when performing a phone review with a patient. The MRI I was presented with had an image quality that was circa 1990. Since we see this from time to time, I thought it was…read more