Differential Diagnosis

Question 1

Key things to do

Answer 1

Listen to your patient
Ask relevant ?s
Screen for serious disease
Know your anatomy
Perform appropriate tests
Think on your feet

Question 2

Diff Dx helps determine what

Answer 2

1. if appropriate for PT
2. any immediate needs (ER?)
3. Serious medical condition and should notify physician?
4. Do they need further tests and measures before you can decide if PT is appropriate?

Question 3

History ?s should tell you

Answer 3

Initial clinical hypothesis
Musculoskeletal vs neuro vs…
Chronicity

Question 4

Age

Answer 4

epidemiology

Question 5

Occumpation

Answer 5

physical or rep labor

Question 6

Cheif complaint

Answer 6

new or longlasting

acute or chronic

Question 7

mechanism of injury

Answer 7

were they in a particular posture

Question 8

Onset of injury

Answer 8

slow or sudden

Question 9

previous history of injury

Answer 9

including all body areas

Question 10

bilateral symptoms

Answer 10

more serious

Question 11

Bladder or bowel

Answer 11

more serious

Question 12

Pain questions

Answer 12

worse, same, improving?
constant, periodic?
associated with?
quality of pain?

Question 13

Neurological exam

Answer 13

Sensory testing
Myotomal testing
Refelxes
Provocation

Question 14

Sensory testing

Answer 14

dematomal vs peripheral
Light touch - hypoesthesia/anterolateral
Pinprick - anesthesia/lateral spinothalamic

Question 15

Myotomal muscle testing

Answer 15

spinal versus peripheral

Nerve conduction vs weakness

Question 16

Reflexes

Answer 16

UPN vs LMN

Question 17

Provocation

Answer 17

SLR, slump, prone knee, flexion tests

neural tissue provocation testing

Question 18

L2

Answer 18

Hip flexion, psoas

Periph = femoral

Question 19

L3

Answer 19

knee extension

Periph = femoral

Question 20

L4

Answer 20

dorsiflexion

Periph = deep peroneal

Question 21

L5

Answer 21

great toe extension, hip abduction

periph = deep peroneal, superior gluteal

Question 22

L5-S1

Answer 22

knee flexion, ankle eversion

periph = sciatic, sup peroneal

Question 23

S1

Answer 23

plantarflexion

Periph = tibial

Question 24

Reflex testing L3

Answer 24

patella

Question 25

Refelx testing L4

Answer 25

ant tib

Question 26

Reflex testing L5

Answer 26

glut med

Question 27

Reflex testing L5-S1

Answer 27

medial hamstring

Question 28

Reflex testing S1-2

Answer 28

achilles

Question 29

Red flags for cancer

Answer 29

1. Severe night pain
2. constant unremitting pain unaffected by position, medication and non reproducible
3. Pain without history of onset
4. decreased appetite, weight loss, fatigue, night sweats

Question 30

Red flags for return to physician - Cardio

Answer 30

SOB, heavy chest, pulsating pain anywhere in body, selling without injury

Question 31

Red flags for return to physician - GI

Answer 31

severe abdominal pain, heartburn or indigestion, frequent nausea, changes in bowel or bladder fucntion, unusual menstrual irregularities

Question 32

Red flags for return to physician - neuro

Answer 32

hearing, severe headaches, problems swallowing or with speech, vision changes, balance issues, falling, fainting, numbness in face

Question 33

Red flags for retunr to physi - musculoskeletal

Answer 33

swelling and redness in any joint without history of injury

Question 34

Systemic with low back

Answer 34

kidney pain

PVD - numbness and tingling pain

Question 35

Hyperreflexia

Answer 35

UMN

Question 36

Hyporeflexia

Answer 36

LMN

Question 37

Dermatomal/Myotomal

Answer 37

nerve root issue

Question 38

Peripheral nerve

Answer 38

nerve issue