DR Tom White

1/100 Main Rd
MAIN QLD 4000
23/07/21
RE: Ms Case One, 01/01/2000, 1/100 Road Rd QLD 4000

Dear Dr, White

Ms Case One a 50-year-old mutual patient of ours who presented to me on the 20/07/21
with severe, intermittent and progressive, left shoulder pain.

During the history and physical examination, the following findings were noted. PR 86, RR
18, BP 130/90, BMI 29. Patient appeared pale and unwell with conjunctiva pallor. Peripheral
pulses were slightly reduced at 2+, apex beat was displaced and palpated between mid-
clavicular and axillary line. Haemoglobin count was low at 105.

AROM was reduced by 50% in cervical spine in movements of left rotation and left lateral
flexion. Left shoulder had a decreased ROM and was painful in all ranges. Cervical spine
tension present with tightness of paravertebral muscles. Joint restrictions present between
C4-C7. Orthopaedic testing resulted in a positive cervical kemp’s, and negative O’briens,
Neers and Hawkin’s Kennedy. X-ray showed a clear cell chondrosarcoma with osteolytic
lesions present between left humeral head and neck, with associated pathological fracture.
In regard to medication, the patient is taking nurofen and Altace and also has osteoarthritis.

Ms Case One has been under my care for her osteoarthritis, and I have provided general
chiropractic care to her through mobilisation and manual adjustments.

I am referring Ms case One to you for further evaluation and discussion.

Please feel free to contact me anytime should you require further information.

Sincerely

Dr Chelsea Graving
Chiropractor
CQU Brisbane 160 Ann st
0400000000

Attached: Xray and bloods