[doctor] hey dylan what's going on so i lift quite a bit of weights i try to stay in shape as much as i can i'm not like normal people i lift heavy weights and my elbow is extremely sore which elbow is it
[patient] actually it's both my elbows but my right elbow is hurting me the most
[doctor] okay and you said you lift a lot of weights
[patient] mm-hmm
[doctor] did you play any sports when you were younger
[patient] no anything you can think of primarily it was basketball baseball and football
[doctor] okay and did your elbows hurt at that time or is this a a new injury
[patient] it's new
[doctor] when did it start
[patient] probably year and a half ago
[doctor] okay on both elbows about a year and a half ago
[patient] yeah
[doctor] okay have you taken anything for the pain
[patient] ibuprofen eight hundred milligrams three times a day
[doctor] okay and does anything make it better or worse
[patient] the more i use my hands or my arms the more it hurts
[doctor] okay have you tried icing
[patient] yes
[doctor] does that give you any relief
[patient] no
[doctor] alright is it the inside or outside of your elbows
[patient] inside
[doctor] inside okay let's just do a quick physical exam here i'll take a look at your right elbow first
[patient] mm-hmm
[doctor] if i bend it this way up does it hurt it's your left does that hurt
[patient] yes
[doctor] how about this
[patient] yes
[doctor] okay so pain with both flexion and extension
[patient] mm-hmm
[doctor] looks like you have little bit of limited range of motion on extension not on flexion though you said it hurts right here on the inside of your elbow
[patient] yes
[doctor] okay so pain on the medial side with palpation
[patient] yes
[doctor] alright how about the outside
[patient] no
[doctor] no pain with palpation outside of the elbow you have do you have normal sensation in your fingers
[patient] i think so
[doctor] yeah
[patient] yeah
[doctor] okay great
[patient] good to go
[doctor] sensation is normal to the touch
[patient] yes
[doctor] pulses equal in all extremities how about the left elbow same thing if i bend it this way does that hurt
[patient] not as much
[doctor] how about this way
[patient] not as much
[doctor] alright so little bit of pain on flexion and extension little bit of limited range of motion on extension of the arm how about if you twist like you're opening a door
[patient] yes
[doctor] okay so some pain with torsion and twisting supination what about pronation
[patient] no
[doctor] no pain with pronation on the right side
[patient] mm-hmm
[doctor] same thing on the left
[patient] yes
[doctor] pain with supination no pain with pronation
[patient] correct
[doctor] alright so dylan it took some x-rays coming in looks like you do n't have any any fractures or any bony misalignment which i expect with this kind of injury i do think that what you have is medial epicondylitis which is
[patient] is that golfer's elbow
[doctor] yes same thing have you been golfing a lot
[patient] well not in the past year and a half i've had this for a long time
[doctor] okay also known as pictures elbow
[patient] well i have n't been pitching either
[doctor] hmmm well in any case what i'm gon na have to do is i'm gon na send you up for mri to take another look at this
[patient] mm-hmm
[doctor] that will be our next step so we'll get you scheduled for the mri probably get you in pretty quick here since we're a private practice
[patient] thank god
[doctor] yeah and once you get the mri i'll know a little bit more what i'd like to do is something called a whole blood transfusion have you heard of that before
[patient] no please tell me remind me
[doctor] yeah it should help with the healing of your elbow it's just a procedure we'll stick a needle in your elbow
[patient] you do a stick needle in my elbow
[doctor] mm-hmm and help with some of the healing of your elbow
[patient] so it's kinda like dry needling then
[doctor] no
[patient] not at all
[doctor] what is it
[patient] is it is that that thing where like you take the blood out of like say my my thigh
[doctor] mm-hmm
[patient] and then you literally inject it into my tendon
[doctor] yes
[patient] that it activates the healing
[doctor] yeah that's exactly what it is
[patient] interesting cool
[doctor] yeah
[patient] maybe i have heard about that
[doctor] we've we've had some really good responses from other patients on it so hopefully i mean that should be a good solution for you since you've been having issues with this
[patient] i'm excited
[doctor] yeah and we can hopefully get you scheduled for that in the next couple of weeks it's not not a major procedure and you should heal in the next two weeks so that wo n't be a problem especially considering that you're expecting a newborn soon we want to make sure you're all healed for that
[patient] wow i did n't even say that
[doctor] i read it in your chart
[patient] man you doctors are good
[doctor] yeah anything else going on today
[patient] just trying to figure out how you're doing
[doctor] very good thank you
[patient] you're welcome
[doctor] nice to see you
[patient] you have a good day

Medical orders:
description: mri
order_type: imaging
reason: medial epicondylitis