Dr David W. Brown _ Chiropractic

3633 Camino del Rio S. Suite 102, San Diego, CA 92108 619/260-8086

Feb 16, 2012

Re: Jaime Quesada

To Whom it Concerns:

I have examined Jaime Quesada for his complaint of pain in his right knee. The pain is located over the posterior, medial aspect of the distal femur. The area is very tender to light palpation and Jaime reports that that part of his leg swells and is very painful after walking up and down stairs.

An X-ray examination was performed which has revealed a flocculent excrescence of calcium deposition in the tendon attachment of the medial head of the gastrocnemious muscle. This calcific tendonitis is consistent with the pain, signs and symptoms reported.

Jaime reports that he hurt his knee in an accident a while back and the pain in this knee has been getting worse especially during exertion when it produces swelling. Although the cause of calcific tendonitis is not fully known it is postulated that chronic irritation or tears at the site can begin a process of fibrosis adhesions and eventual deposition of calcium in the tissue leading to stiff, painful muscles.

Treatment starts with rest, ice and ultrasonic diathermy to decrease the inflammation and allow the possibility of the body to re-absorb the calcium deposits. Injection of lidocaine with steroid has been known to help reduce symptoms and surgical decompression is sometimes a last resort.

If at all possible Jaime should