712 - Complex Care of Touring Professional Musician

Case Diagnosis: Dupuytren's Contracture and Undiagnosed Chronic Conditions

Case Description: A 58-year-old male musician presented to the pro bono performing arts medicine clinic for pain and nodules localized along his right hand. He reported initially having surgery to remove the nodules but experienced recurrence across all four limbs. As a touring professional guitarist and painter he had not had consistent medical care over the years. As a multi specialty practice, Physiatry initiated primary care while managing Dupuytren’s contracture. From the initial visit to follow up, the labs demonstrated hemoglobinopathy with erythrocytosis, metabolic syndrome (especially hypertension, and hyperlipidemia) that were not being followed and medically managed.



Discussions: Professional musicians often are uninsured or underinsured. Their health issues go undiagnosed or not treated due to financial, temporal, and geographical restrictions, which limit musicians’ ability to see a physician or obtain treatments. Also, any pathology of the hand can be a tremendous insult to their career. Physiatrists not only are able to understand such unique aspects of musicians’ occupation but also are able to coordinate interprofessional care to optimize function. For patients like musicians where their function is a major aspect of their vocation, injury or disease such a contracture plays a large role in their lifestyle and in the management of their health. Especially with regard to patients who travel for their industry and are often working variable schedules, this can prove to be a barrier in long term monitoring or even awareness of chronic conditions.

Conclusions: There is a biopsychosocial aspect to caring for traveling musicians and physiatrists should play a role in coordinating care.