Moderator EMEDPA Posted July 17, 2012 Moderator Share Posted July 17, 2012 saw one of these last night. really unimpressive exam yet multiple spinous process fxs on plain film....which were treated symptomatically.... Fracture, clay-shoveler's: An uncommon breakage of the spine of the vertebrae from the lower neck or upper back as a result of stress. Clay-shoveler's fracture usually occurs in laborers who perform activities involving lifting weights rapidly with the arms extended. Examples of these activities include shoveling soil, rubble or snow up and over the head backwards, using a pickax or scythe, and pulling out roots. The shear force of the muscles (trapezius and rhomboid muscles) pulling on the spine at the base of the neck actually tears off the bone of the spine. Symptoms of clay-shoveler's fracture include burning, "knife-like" pain at the level of the fractured spine between the upper shoulder blades. The pain can sharply increase with repeated activity that strains the muscles of the upper back. The broken spine and nearby muscles are exquisitely tender. Clay-shoveler's fracture is diagnosed by x-ray examination of the spine. While the intense pain gradually subsides in days to weeks, the area can intermittently develop burning pain with certain activities that involve prolonged extending of the arms (like computer work). Most patients require no treatment. Pain medications, physical therapy, and massage can be of help. Occasionally, surgical removal of the tip of the broken spine is performed for those with longstanding pain. Link to comment Share on other sites More sharing options...
ToppDog Posted July 17, 2012 Share Posted July 17, 2012 Cool! Thanks for that. Never heard of that one before :) Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 17, 2012 Author Moderator Share Posted July 17, 2012 pt had minimal point tenderness at c7 prominence of 1 weeks duration. full rom. otherwise nl exam. I almost didn't xray them, although the tx would have been the same without the xray. Link to comment Share on other sites More sharing options...
chiaroscuro27 Posted July 18, 2012 Share Posted July 18, 2012 Interesting. We learned about these in didactic year, but I've yet to see it in practice. Link to comment Share on other sites More sharing options...
discogenic Posted July 18, 2012 Share Posted July 18, 2012 I'm assuming the patient had one of those shovel-ready jobs?:;;D: Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 18, 2012 Author Moderator Share Posted July 18, 2012 I'm assuming the patient had one of those shovel-ready jobs?:;;D: yup, and apparently he couldn't "handle" it.... Link to comment Share on other sites More sharing options...
discogenic Posted July 19, 2012 Share Posted July 19, 2012 Poor guy. He's really "dug" himself into a hole this time. Link to comment Share on other sites More sharing options...
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