Back Appearance NormalSwellingRednessErythemaDeformityScars Palpation 1. Top Right 2. Top Left 3. Mid Right 4. Mid Left 5. Low Right 6. Low Left 7. Other Observed Abnormality? Yes NoSensation Intact? Yes NoMoves Extremities w/o Deficit? Yes NoStrength - Select -12345 Deep Tendon Reflexes - Select -01234 Range of MotionFlexion FullLimited LevelPainExplain Extension FullLimited LevelPainExplain Sidebending Right FullLimited LevelPainExplain Sidebending Left FullLimited LevelPainExplain Rotation FullLimited LevelPainExplain Procedure Note Consent Skin Cleaned with Chlohexadine Other Tender Points Injected with:Dextrose PRP Joint Injection:Dextrose PRP Stem Cell Resolution of Symptoms? Yes No Tolerated Well? Yes No Procedural Sedation: Medication 1: - Select -AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscel DoseMedication 2: - Select -AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscel DoseMedication 3: - Select -AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscel Dose
