Locomotor PCP presentations

Question 1

Knee pain:

What site things are important to determine?

Answer 1

Where in the joint
Uni- vs bilateral
Any other joints

Question 2

Knee pain:

What can anterior pain suggest?

Answer 2

Osteoarthritis

Patellar problems

Question 3

Knee pain:

What can lateral/medial pain suggest?

Answer 3

Ligament strain

Meniscal tear

Question 4

Knee pain:

What can posterior pain suggest?

Answer 4

Hamstring strain
Bursitis
Baker’s cyst
DVT

Question 5

Knee pain:

Important time questions

Answer 5

Onset
Is it worse in the morning?
Is it worse after exercise?

Question 6

Knee pain:

Context

Answer 6

If it’s an injury - the exact mechanism

If it’s chronic - how it’s affecting their life

Any skin injury (infection)

Long period of immobility (DVT)

Question 7

Knee pain:

Associated features

Answer 7

Noises (clicking, popping)
Swelling
Redness
Reduced ROM
LOF due to stiffness, locking, giving way etc
Fever

Question 8

Shoulder pain:

What are the extrinsic causes?

Answer 8

Myocardial infarction
Diaphragmatic irritation (gas, peritonitis)
Neck impingement (trauma, lung tumour)

Question 9

Shoulder pain:

Site questions

Answer 9

Where exactly in the joint?
Uni- vs bilateral
Is it exacerbated by movement? (intrinsic vs extrinsic)

Question 10

Shoulder pain:

Aggravating factors

Answer 10

Specific movements that produce pain

Question 11

Shoulder pain:

Associated features

Answer 11

Swelling
Redness
Reduced ROM
MI stuff
Cancer stuff

Question 12

“MI stuff” associated features

Answer 12

Nausea
SOB
Sweating
Crushing chest pain

Question 13

Shoulder pain:

Context

Answer 13

Injury (to shoulder or neck)

Lap surgery

Question 14

What’s the movement that produces pain in subacromial bursitis?

Answer 14

Painful arc syndrome: 60-120”

Question 15

Back pain:

Red flags

Answer 15

• Age (over 50 under 20)
• Cancer Hx or suspicion
• IVDU
• Systemic disease including GCCs
• Sciatica or other neurological defect
• Pain not relieved by rest
• Pain for more than a month & unresponsive to usual Tx

Question 16

Back pain:

Associated features

Answer 16

Reduced ROM
Cancer stuff
Leg pins & needles
Problems voiding, defecating, sexual fn
Dysuria, fever, malaise

Question 17

Back pain:

Context

Answer 17

IVDU

Question 18

Back pain:

Personal history/medications

Answer 18

Cancer
GCCs
Cardio risk factors (for AAA)