MSK WORKBOOOK Flashcards
What do you do prior to commencing your subjective assessment?
Introduce yourself
Check patients details, ask them their name preference
Obtain next of kin’s details, including a contact number
Get consent
How would you plan your subjective assessment?
PC HPC SQ PMH DH SH AGGS/EASES 24 hour pattern
What to include in HPC?
Onset- gradual/sudden
Cause- MOI- trauma, position of injury, bleeding, swelling, insidious, precipitating factors, change in posture, overuse, misuse any change in lifestyle, degenerative
Pattern of symtoms- worsening, improving, episodic, no change
What further questions would you ask regarding symtoms?
Sin factors
AGGS
Eases
Daily pattern
What information would you want to include in the body chart?
Area of pain, if more than 1 are they related
Type of pain- ache, sharp, burning, stabbing
Depth- deep or superficial
Frequency- constant, unremitting, intermittent, severity-VAS
Abnormal sensation- pins and needles, numbness
What do you want to find out from the past medical history?
Previous incidents and injuries
Investigations and results
Other medical conditions- threads
Allergies
What does THREADS stand for?
Thyroid disorders Heart problems Rheumatoid arthritis Epilepsy Asthma or other respiratory problems Diabetes Surgery
What do you want to obtain from their drug history?
Regular medications- what they are for
Pain recliner- frequency, if they manage their plan, timing
Steroids and anticoagulants
What would you ask in your social history?
Why do you ask it?
Employment status- full time/ part time/% voluntary, type of job, sedentary/ active, full duties
Hobbies- are they able to do, aim to get back to, at active
ADLS- carers, any caring duties, stairs, getting washed and dressed
What are red flags and what do they indicate?
Concern signs of serious pathology in patients that require further investigation
What other flag colours are there and what do they indicate?
Yellow- psychosocial factors, depression patient beliefs about their condition
Blue- relate to an individuals perception of work
Black- work conditions that could inhibit rehab, such as a job requiring heavy lifting or the wrong height of a desk in a fixed work station
Orange- abnormal psychological processes or drug abuse. They indicate referral to a specialist
What signs or symptoms would indicate a more serious spinal pathology?
PMH- carcinoma Throacic pain Systemic steroids Drug abuse Unexplained weight loss Widespread neurology Structural deformity Constant, progressive, non-mechanical pain
If there are suspicious clinical features, and if pain has not settled in 6/52 further investigations should be considered
What is cauda equina syndrome?
Difficulty passing urine
Loss of anal sphincter tone/ incontinence
Saddle anaesthesia about the anus
Widespread or progressive weakness in the legs/ gait disturbance
Erectile dysfunction or changes in sexual function
Red flag for infection would present with the following symptoms
General feeling unwell
High temperature
IVDU
Recent surgery/ open wounds
Fractures red flag symtoms
Trauma Constant pain, worse on weight bearing Swelling/bruising Steroid use Osteoporosis
