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White, a neurosurgeon at City Hospital Newtown, regarding a 45-year-old patient named Mr. George Poulos. The referral is for further investigations and management of presumptive discogenic low back pain associated with radiculopathy. The letter details the patient's history, including a two-day history of sudden severe lower back pain with a clicking sensation, which he managed with Panadeine Forte. Initial examination revealed loss of lumbar lordosis, painful flexion, and limited extension, but normal lateral flexion, rotation, and sensation. Paracetamol and rest were prescribed. A week later, the patient's condition worsened, characterized by increased pain, near immobility, and tingling in his right calf. The second examination indicated no lumbar flexion, restricted movement due to pain, decreased SLR, loss of right ankle reflexes, and diminished light touch sensation over the lateral distal calf and plantar aspect of the foot. The referring doctor believes the patient requires an MRI and advice regarding the likelihood of surgery. The letter also notes the patient's significant risk factors, including heavy smoking and excessive alcohol consumption, and lists his allergies: pethidine, penicillin, unspecified radiographic contrast agent, and possibly iodine. The referring doctor expresses gratitude for Dr. White's expert care and invites further contact if more information is needed.",{"@graph":69,"@context":105},[70,84],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/referral-letter-mr-george-poulos/26965/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/referral-letter-mr-george-poulos/26965.png","ImageObject",300,407,{"name":92,"@type":93},"Levi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-19","2026-05-08",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction","https://schema.org",{"og:url":107,"og:type":108,"og:title":65,"og:site_name":95,"og:description":67},"https://docshare.wps.com/document/referral-letter-mr-george-poulos/26965","article",{"robots":110,"canonical":107},"index,follow",{"doc_id":112,"site_id":62},26965,1778200769,{"code":4,"msg":5,"data":115},{"doc_id":112,"user_id":116,"nickname":92,"user_avatar":117,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":66,"file_id":118,"file_url":119,"file_type":120,"file_size":121,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":122,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":66,"faqs":66,"seo_title":123,"seo_description":67,"update_tm":113,"read_time":81},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","cbCaibzKticwLdav","https://ap.wps.com/l/cbCaibzKticwLdav","pdf",144799,"English","Referral Letter Mr George Poulos | PDF"]