Comes to clinic today with problems with recurrent bursitis. He states that he did make an appointment to see me several weeks ago because of 1 episode of bright red bleeding per rectum. He states he had never had this occur before, and it has not occurred since. I discussed the different possibilities of this condition. He has definitely decided not to pursue the matter. He is asymptomatic at this time.
What is troubling him at this time is recurrent tendinitis to the left arm (this has been injected successfully with cortisone on multiple occasions), as well as intermittent problems of left hip pain, which also seems to be tendinitis/bursitis in nature. Smokes 2 packs of cigarettes per day and continues to do so despite a rather severe episode of bronchitis earlier this year.
On examination, he is in no acute distress. Blood pressure 120/74. HEENT clear. Chest clear. Cardiac examination reveals regular rate and rhythm without murmur. Patient has marked trigger point on the lateral epicondyle. He is asymptomatic to his hip at this time, and examination is benign.
After discussing the different possibilities, elected to try conservative therapy. Tennis elbow armband is placed to the left arm. He is begun on Anaprox DS on a trial basis. If this gives adequate relief, I would just have him use it on a p.r.n. basis. If, however, he continues to have significant pain, would recommend return to clinic for trigger point injection.
FOOTNOTE
Line 19. Has continues was edited to continues.
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