The patient was a 23-year-old woman referred to physical therapy for the primary treatment of knee pain which began 4 months prior following a twisting injury. During the patient interview, the patient also complained of neck pain and numbness and tingling in her bilateral hands and feet which began 6 weeks earlier after jumping into a 2 meter pool head first and striking her head on the floor of
... [Show full abstract] the pool. Due to concern over a serious cervical spine injury, the physical therapist focused his initial physical examination on the patient's cervical spine. Physical examination findings were remarkable for midline cervical spine tenderness and decreased sensation throughout both hands and feet. Cervical spine radiographs were ordered, which revealed a cortical irregularity along the anterior aspect of the superior endplate of the C7 vertebral body, which was concerning for an anterior-superior compression fracture. Computed tomography scanning was completed for further evaluate the area of injury and revealed minimally displaced anterior compression fractures within the C7, T1, T2, and T3 vertebral bodies. Due to the paresthesias in the upper and lower extremities, magnetic resonance imaging was completed, which demonstrated no evidence for significant central canal or foraminal stenoses. The patient was referred to a neurosurgeon who recommended conservative management.J Orthop Sports Phys Ther 2010;40(3):189. doi:10.2519/jospt.2010.0405.