General Ortho Disease Reference

Question 1

General Ortho Disease Reference

Answer 1

1. History
   
   1. Age/Sex/Occupation
   2. CC: Chief Complaint
   3. Onset of pain/mass/other
   4. Position
   5. Q uality/Quantity
      
      1. Pain: sharp, dull, ache, pounding, throbbing
      2. Mass: hard, soft
   6. R adiation
   7. Severity
      
      1. Scale out of 10
      2. Better, worse, same
   8. T iming
      
      1. Activity, night, rest, wax/wane, certain actions
   9. AA
   10. Assoc Symptoms
       
       1. Neurologic
          
          1. Shooting, electric shock, numbness, tingling, bowel, bladder, loss sensation, loss power, weakness
       2. Mechanical
          
          1. Locking, clicking, instability
       3. Constitutional
          
          1. Weight loss, appetite change, night pain, night sweating
          2. Fever, chills
       4. Local
          
          1. colour change, drainage, other
   11. PSHX, PMHX, Meds, Allergies
       
       1. Start with this as a screening question
   12. FHx
       
       1. Cancer, Related Diseases
   13. Perinatal Hx, Birth Hx, OB/Gyn Hx for Peds
   14. Devp Hx and Milestones
   15. Social Hx (EtOH, tobacco), Work Exposures (asbestos, TB)
   16. Handedness, Sports
   17. Function and ADLs
       
       1. Harris Hip Score, Performance Loss, Etc
   18. ROS
       
       1. Head to Toe
       2. Related areas to look for as a general physician
2. Physical Exam
   
   1. General Observation
      
      1. Appropriately disrobe patient
      2. Fresh vitals
      3. General health observation
   2. Look
      
      1. Gait
      2. S welling
      3. E rythema
      4. A trophy
      5. D efortmity
      6. S kin changes
      7. LLD
   3. Feel
      
      1. Palpate all anatomy and bony prominences
   4. Move
      
      1. ROM N values
   5. Special Test
      
      1. By Joint and for what
   6. NV Exam
   7. JAB
   8. Opposite limb
   9. General Medical Exam
3. Imaging
   
   1. Xrays
   2. other modalities
4. Diagnosis or DDx
   
   1. Implications (AVN risk, infection, etc.)
5. Acute Rx and work-up
   
   1. Reduce/splint/traction, ER tests/consults, admit, further imaging, plan OR for trauma
6. Treatment plan
   
   1. Goals
   2. Non-operative Rx (options, follow-up)
   3. Operative Rx
      
      1. Options
   4. Consent
      
      1. Outcome
      2. Risks
         
         1. immediate
         2. late
   5. Pre-op
      
      1. labs (x-match), tests (ECK, CXR), old OR reports, consults
   6. Post the case
      
      1. patient, surgery, implants, adjuncts (teams, consultants, special equipment), table, flouro, monitoring
7. Technique
   
   1. Position, ABX
   2. Incision, approach, fixation
8. Post-op
   
   1. NV exam, compartment check
   2. Xrays
   3. Immobilization
   4. Weight Bearing Status, Physio
9. Disposition and Follow-up
   
   1. F/U plan
10. Complications
    
    1. List potential complications
    2. Prevention
    3. Treatment