Individuals with spinal cord injury or dysfunction represent unique diagnostic challenges when they present with symptoms of generalized malaise or "feeling lousy." Those individuals with injury or dysfunction at or above the T6 level are specifically at risk for the phenomenon known as autonomic dysreflexia, which is a medical emergency. The underlying cause of autonomic dysreflexia as well as other secondary complications in the patient with a spinal cord injury can best be uncovered through a comprehensive review of systems, which encompasses constitutional, head, cardiovascular, gastrointestinal, genitourinary, musculoskeletal, respiratory, skin, neurologic, psychiatric, endocrinologic, hematologic, and immunologic issues.
Address correspondence to Dr Peter H. Gorman, Kernan Orthopaedics and Rehabilitation Hospital, 2200 Kernan Drive, Baltimore, MD 21207, firstname.lastname@example.org.
Relationship Disclosure: Dr Gorman anticipates receiving research support for a clinical trial from Geron and has served as an expert witness. Dr Gorman has received a grant from the US Department of Defense for a clinical trial on aquatic therapy and Lokomat therapy in spinal cord injury.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Gorman reports no disclosure.