ABSTRACT
Chronic pain has become a major public health problem. Often, the availability of entitlement programs as well as psychosocial, occupational, and other nonmedical factors-rather than objective pathophysiology-are major contributors to disability. In this chapter, the authors discuss the relationship between impairment and disability and detail factors likely to predict or contribute to adverse clinical outcome and disability. Guidelines for disability prevention also are examined.
Subject(s)
Disability Evaluation , Occupational Diseases/rehabilitation , Pain, Intractable/rehabilitation , Chronic Disease , Female , Humans , Long-Term Care , Male , Occupational Diseases/diagnosis , Pain Measurement , Pain, Intractable/diagnosis , Prognosis , Risk Assessment , Syndrome , Treatment Outcome , United StatesABSTRACT
Two cases are presented. Case #1, a 27-year-old Caucasian male presented with chronic right leg pain. Case 2 was a 23-year-old Caucasian female with right fifth finger pain. The clinical examination was benign except for mild tenderness of many years duration. No deformities were present in the male patient, the female patient did exhibit mild clinodactyly. The pain was described as constant, low grade, and dull. Plain roentgenograms of both patients demonstrated a hyperostotic process typical of melorheostosis and the bone scans demonstrated increased bone activity. A CAT scan demonstrated both endosteal and periosteal hyperostosis in our male patient. The biopsies of both patients were consistent with the clinical diagnosis of melorheostosis. A discussion and review of the literature covering this process is presented.
