25 year-old-female with a chief complaint of back pain...
You are seeing a 25 year-old-female with a chief complaint of back pain. The patient was involved in a minor car accident this morning, and is experiencing severe, sharp pain in her low back. The pain is rated 8/10 in severity. The pain is aggravated by movement, and the patient has decreased range of motion in all planes. You perform a complete osteopathic examination. Which of the following physical exam findings is not consistent with acute somatic dysfunction?
- Ropy tissue with increased resistance
- Warm, moist tissue
- Edematous, erythematous tissue
- Local increase in tone; spasticity
- Sharp, severe tenderness to palpation
Ropy tissue with increased resistance
Somatic dysfunction can be acute or chronic. It is possible to differentiate acute changes from chronic changes on history and physical examination. Findings consistent with chronic somatic dysfunction include the following:
-Thin, smooth texture
-Cool, pale, dry skin overlying the area of dysfunction
-Tenderness is present, but it is described as dull or achy
-Edema and erythema are absent
-Ropy tissue with increased resistance
-Decreased muscle tone; sluggish muscle movements
This answer selection is describing ropy tissue with increased resistance. These changes would be seen in chronic somatic dysfunction, and are NOT consistent with acute somatic dysfunction.