Demonstrates how to organize the history and examination interview, and to interpret the findings using a 'process' that helps to determine what is the most likely type and source of the pathology.
Organizes the content by the presenting primary symptom.
Uses outlines, lists, and tables within each symptom chapter to make reference easy.
Follows a standard format throughout each symptom chapter that includes…
A brief description of the symptom and its variations.
Red flags indicating the need for special concern
Tables of possible conditions, organized by how common or rare they are.
Identifies conditions that might require emergency or urgent attention.
Describes the differential diagnosis of each symptom, with careful attention to the findings in the history and examination.
Discusses each of the conditions listed in the table of possible diagnoses, focusing on the key findings that would rule a condition more or less likely.
Lists tests that might be needed to reach a definitive differential diagnosis.
Facilitates decision making regarding whether physical therapy is…not indicated, indicated after referral or consultation with another healthcare practitioner, or appropriate without additional referral or consultation.
Author(s): Todd E. Davenport, James Gordon, Kornelia Kulig
Edition: 1
Publisher: F.A. Davis Company
Year: 2012
Language: English
Pages: 1408
City: Philadelphia
Copyright
Preface
Contributors
Reviewers
Manuscript Support
Acknowledgments and Dedication
Contents in Brief
Contents
Section I:
Foundations
Chapter 1:
Why Should Physical Therapists Know About Diagnosis?
Introduction
Five Critical Issues Frame the Topic of Diagnosis by Physical Therapists
Critical Issue 1: What is a Diagnosis?
Critical Issue 2: Should Physical Therapists Diagnose Pathology?
Critical Issue 3: Should Physical Therapists Adopt a Different Definition for Diagnosis Than Other Health Professionals Use?
Critical Issue 4: Should Physical Therapists be Expected to Diagnose Given the Current Legal Environment?
Critical Issue 5: What Information Should Physical Therapists Use to Make Decisions About Treatment and Prognosis?
Conclusion
Chapter 2:
Beyond the Diagnosis: The Search for Underlying Etiology
Introduction
Physical Therapists Use the Diagnostic Label
Physical Therapists Elaborate on the Diagnostic Label
The Diagnostic Label Alone is Insufficient to Guide Physical Therapists
A Process Guides Physical Therapists’ Search for an Underlying Etiology
Physical Therapists Identify the Functional Chief Concern
Physical Therapists Perform Task and Movement Analyses
Physical Therapists Create and Test Hypothetical Relationships
The Search for an Underlying Etiology is Dynamic and Ongoing
Conclusion
Chapter 3:
Diagnostic Reasoning
Introduction
Both Diagnosis and Medical Screening Have Roles in Physical Therapy
Diagnosis is a Unique Combination of Reasoning Patterns
Backward Reasoning Involves Creation and Testing of Clinical Hypotheses
Forward Reasoning Involves the Attempt to Recognize Patterns in Clinical Presentation
Experts Create “Small Worlds” of Information to Use in Diagnostic Reasoning
Preferred Diagnostic Reasoning Processes Depend on the Clinician and the Case
Conclusion
Chapter 4:
How to Use This Book
Introduction
Principle of “Economy of Diagnoses”
The Diagnostic Process
Barriers to Communication
The Starting Point: Identify the Patient’s Chief Concern
Symptoms Versus Signs
Special Concerns
TIM VaDeTuCoNe: A Database of Possible Causes
Remote Versus Local Source of Pain
What Follows the Making of a TIM VaDeTuCoNe List?
Conclusion
Chapter 5:
Case Demonstration: Shoulder
Case Description
Case Outcome
Section II:
Adult Pain
Chapter 6:
Diagnostic Considerations of Pain
Introduction
All People Share Common Nociceptive Processes
Nociceptors Respond to Various Forms of Tissue Injury
Nociceptors Transmit Pain Signals Along Organized Neural Pathways
The Perception of Pain Severity Depends on Anatomical, Physiological, and Cognitive Factors
A “Gate” Controls the Transmission of Pain Signals at the Spinal Cord and Elsewhere
Input from the Cerebral Cortex and Midbrain Also Plays a Role in the Gate’s Function
Emotional, Anticipatory, and Previously Learned Responses Also Modulate Pain Severity
Timing of Pain Suggests the Etiology of Underlying Pathology
Factors in the History and Physical Examination Can Implicate Affected Tissues
Descriptions of Pain May Relate to Either Injured Tissues or Emotional Features
Locations of Pain and Its Underlying Cause May Differ
Misinterpretation by the Central Nervous System Causes Referred Pain
Long-Term Pain Causes Cyclic Anatomical, Physiological, and Cognitive-Behavioral Changes
Prolonged Activation of Nociceptive Pathways Causes Maladaptations Throughout the Nervous System
The Sympathetic Nervous System Can Contribute to the Perception of Pain
Psychological and Social Factors Perpetuate Pain Through Behavior Reinforcement
Conclusion
Chapter 7:
Headaches
Description of the Symptom
Overview of Headache
Description of Conditions That May Lead to Headache
Remote
Local
Chapter 8:
Temporomandibular Joint and Facial Pain
Description of the Symptom
Overview of Temporomandibular Joint and Facial Pain
Description of Conditions That May Lead to Temporomandibular Joint and Facial Pain
Remote
Local
Chapter 9:
Case Demonstration: Jaw Pain
Case Description
Case Outcome
Chapter 10:
Neck Pain
Description of the Symptom
Overview of Neck Pain
Description of Conditions That May Lead to Neck Pain
Remote
Local
Description of the Symptom
Chapter 11:
Shoulder Pain
Overview of Shoulder Pain
Description of Conditions That May Lead to Shoulder Pain
Remote
Local
Chapter 12:
Elbow Pain
Description of the Symptom
Overview of Elbow Pain
Description of Conditions That May Lead to Elbow Pain
Remote
Local
Chapter 13:
Wrist and Hand Pain
Description of the Symptom
Overview of Wrist and Hand Pain
Description of Conditions That May Lead to Wrist and Hand Pain
Remote
Local
Chapter 14:
Anterior Thorax Pain
Description of the Symptom
Overview of Anterior Thorax Pain
Description of Conditions That May Lead to Anterior Thorax Pain
Remote
Local
Chapter 15:
Case Demonstration: Chest Pain
Case Description
Case Outcome
Chapter 16:
Posterior Thorax Pain
Description of the Symptom
Overview of Posterior Thorax Pain
Description of Conditions That May Lead to Posterior Thorax Pain
Remote
Local
Chapter 17:
Case Demonstration: Infrascapular Pain
Case Description
Case Outcome
Chapter 18:
Lumbar Pain
Description of the Symptom
Overview of Lumbar Pain
Description of Conditions That May Lead to Lumbar Pain
Remote
Local
Chapter 19:
Hip Pain
Description of the Symptom
Overview of Hip Pain
Description of Conditions That May Lead to Hip Pain
Remote
Local
Chapter 20:
Case Demonstration: Hip Pain
Case Description
Case Outcome
Chapter 21:
Knee Pain
Description of the Symptom
Overview of Knee Pain
Description of Conditions That May Lead to Knee Pain
Remote
Local
Chapter 22:
Lower Leg Pain
Description of the Symptom
Overview of Lower Leg Pain
Description of Conditions That May Lead to Lower Leg Pain
Remote
Local
Chapter 23:
Ankle Pain
Description of the Symptom
Overview of Ankle Pain
Description of Conditions That May Lead to Ankle Pain
Remote
Local
Chapter 24:
Foot Pain
Description of the Symptom
Overview of Foot Pain
Description of Conditions That May Lead to Foot Pain
Remote
Local
Section III:
Adult Non-Pain
Chapter 25:
Foundations of Neurological Differential Diagnosis
Introduction
Nervous System Pathology is Important to Consider in Diagnostic Reasoning
Summary of Neurological Differential Diagnosis
Chart Review
History/Subjective Examination
Objective Examination
Clinical Neurological Tests
Diagnostic Impression
Linking Examination Findings to Neuroanatomy
Anatomy and Functions of the Nervous System
Neurological Impairments and Associated Anatomical Regions
Conclusion
Chapter 26:
Cardiovascular and Pulmonary Clues from Examination
Introduction
General Observation is an Important Initial Basis for Diagnosing Cardiovascular and Pulmonary Pathologies
Assessment of Skin Provides Clues Regarding the Status of Cardiac and Pulmonary Function
Color May Indicate the Presence of Impaired Blood Oxygenation
Surface Temperature Reflects the Rate of Underlying Tissue Metabolism
Mobility and Turgor Suggest the Status of Nutrition, Hydration, and Vascular Competence
Lesions and Marks can Provide Clues to the Presence of Important Medical Comorbidities
Examination of the Thorax Provides Diagnostic Information Regarding the Cardiovascular and Pulmonary Systems
Configuration of the Chest Wall May Indicate the Presence of Chronic Pulmonary Pathology
Chest Wall Excursion Reflects the Status of Ventilatory Mechanics
Palpation of the Thorax Provides Information Regarding the Physical Composition and Orientation of Thoracic Organs
Tonal Quality of Sound Transmitted Through the Thorax Provides Information Regarding the Composition of the Lungs
Vital Signs Provide Direct Information Regarding Various Aspects of Cardiovascular and Pulmonary Functioning
Heart Rate Indicates the Cardiovascular System’s Response to Different Levels of Activity
Pulse Rhythm Suggests the Status of Electrical Conduction and Cardiac Output
Pulse Quality Provides Information Regarding the Status of Contractile Force and Cardiac Output
Blood Pressure Responds to Changes in Position and Activity in a Predictable Fashion and Provides Important Clues to Organ Perfu
Respiratory Rate Suggests the Status of Ventilatory Mechanics and Blood Oxygenation
Heart and Lung Sounds Reveal Clues About Cardiac and Pulmonary Pathology
Cardiac Auscultation
Pulmonary Auscultation
Conclusion
Chapter 27:
Dizziness
Description of the Symptom
Overview of Dizziness
Description of Conditions That May Lead to Dizziness
Chapter 28:
Loss of Balance and Falls
Description of the Symptom
Overview of Loss of Balance and Falls
Description of Conditions That May Lead to Loss of Balance and Falls
Chapter 29:
Sensory Abnormalities
Description of the Symptom
Overview of Sensory Abnormalities
Auditory Abnormalities
Gustatory Abnormalities
Olfactory Abnormalities
Proprioceptive Abnormalities
Tactile Abnormalities
Visual Abnormalities
Description of Conditions That May Lead to Sensory Abnormalities
Chapter 30:
Abnormal Movement
Description of the Symptom
Overview of Abnormal Movement
Description of Conditions That May Lead to Abnormal Movement
Chapter 31:
Problems of Cognition, Communication, and Behavior
Description of the Symptom
Description of Conditions That May Lead to Problems with Cognition, Communication, and Behavior
Overview of Problems with Cognition, Communication, and Behavior
Chapter 32:
Stiffness
Description of the Symptom
Overview of Stiffness
Description of Conditions That May Lead to Stiffness
Chapter 33:
Weakness
Description of the Symptom
Overview of Weakness
Description of Conditions That May Lead to Weakness
Chapter 34:
Case Demonstration: Inability to Stand
Case Description
Case Outcome
Chapter 35:
Palpitations
Description of the Symptom
Overview of Palpitations
Description of Conditions That May Lead to Palpitations
Chapter 36:
Persistent Cough
Description of the Symptom
Overview of Persistent Cough
Description of Conditions That May Lead to Persistent Cough
Chapter 37:
Dyspnea
Description of the Symptom
Overview of Dyspnea
Description of Conditions That May Lead to Dyspnea
Chapter 38:
Edema
Description of the Symptom
Overview of Edema
Description of Conditions That May Lead to Edema
Chapter 39:
Case Demonstration: Edema and Shoulder Pain
Case Description
Case Outcome
Chapter 40:
Failure of Wounds to Heal
Description of the Symptom
Overview of Wounds That Fail to Heal
Description of Conditions That May Lead to Failure of Wounds to Heal
Chapter 41:
Case Demonstration: Fatigue
Case Description
Case Outcome
Section IV:
Children
Chapter 42:
Special Diagnostic Issues in Children
Introduction
Special Features of History Taking in Children
The Age of a Child is the Defining Feature in Differential Diagnosis
The History is Generally Obtained Secondhand Through the Parent
Obtaining Information About a Child’s Development
Some Pitfalls
Never Forget the Possibility of Child Abuse
Special Features of the Physical Examination of a Child
Get to the Child’s Level
Watch While the Child is Waiting to Be Seen
Potential Problems with Disrobing
Examine the Painful Area Last
Confirmation of Discrepancies
Examining the Child to Obtain Information About the Child’s Development
Differences in Fractures Between Children and Adults
Epiphyseal Fractures
Issues Related to Growth of Bones in Children
Growth of the Long Bones
Growth Disturbances Due to Abnormal Muscle Activity
Leg-Length Discrepancy
Physiological Differences
Mechanical Differences
Other Considerations
Conclusion
Chapter 43:
Elbow Pain in a Child
Description of the Symptom
Overview of Elbow Pain in a Child
Description of Conditions That May Lead to Elbow Pain in a Child
Remote
Local
Chapter 44:
Back Pain in a Child
Description of the Symptom
Overview of Back Pain in a Child
Description of Conditions That May Lead to Back Pain in a Child
Remote
Local
Chapter 45:
Hip Pain in a Child
Description of the Symptom
Overview of Hip Pain in a Child
Description of Conditions That May Lead to Hip Pain in a Child
Remote
Local
Chapter 46:
Case Demonstration: Hip Pain in a Child
Case Description
Case Outcome
Chapter 47:
Knee Pain in a Child
Description of the Symptom
Overview of Knee Pain in a Child
Description of Conditions That May Lead to Knee Pain in a Child
Remote
Local
Chapter 48:
Case Demonstration: Knee Pain and Limping in a Child
Case Description
Case Outcome
Chapter 49:
Shin Pain in a Child
Description of the Symptom
Overview of Shin Pain in a Child
Description of Conditions That May Lead to Shin Pain in a Child
Remote
Local
Chapter 50:
Ankle and Foot Pain in a Child
Description of the Symptom
Overview of Ankle and Foot Pain in a Child
Description of Conditions That May Lead to Ankle and Foot Pain in a Child
Remote
Local
Chapter 51:
Case Demonstration: Foot Pain in a Child
Case Description
Case Outcome
Chapter 52:
Delayed Mobility (Crawling and Walking), Failure to Thrive, and Psychomotor Delay in a Child
Description of the Symptom
Description of Conditions That May Lead to Delayed Mobility, Failure to Thrive, and Psychomotor Delay in a Child
Overview of Delayed Mobility, Failure to Thrive, and Psychomotor Delay in a Child
Chapter 53:
The Child With a Painless Limp
Description of the Symptom
Overview of a Painless Limp in a Child
Causes of Limping
Reduce Pain
Compensate for Muscle Weakness
Accommodate a Deformity
Central Nervous System Dysfunction
Descriptions of Conditions That May Lead to a Painless Limp in a Child
Chapter 54:
Tripping and Falling in a Child
Description of the Symptom
Overview of Tripping and Falling in a Child
Description of Conditions That May Lead to Tripping and Falling in a Child
Description of the Symptom
Chapter 55:
Toe Walking in a Child
Overview of Toe Walking in a Child
Description of Conditions That May Lead to Toe Walking in a Child
Chapter 56:
Joint Contractures in a Child
Description of the Symptom
Overview of Joint Contractures in a Child
Description of Conditions That May Lead to Joint Contractures in a Child
Chapter 57:
Torticollis in a Child
Description of the Symptom
Overview of Torticollis in a Child
Description of Conditions That May Lead to Torticollis in a Child
Chapter 58:
Case Demonstration: Torticollis in a Child
Case Description
Case Outcome
Chapter 59:
Poor Posture and Scoliosis, Kyphosis, and Lordosis in a Child
Description of the Symptom
Overview of Poor Posture and Scoliosis, Kyphosis, and Lordosis in a Child
Scoliosis
Structural Kyphosis
Lordosis
Description of Conditions That May Lead to Poor Posture and Scoliosis, Kyphosis, and Lordosis in a Child
Chapter 60:
Bowed Legs and Knock Knees in a Child
Description of the Symptom
Overview of Bowed Legs and Knock Knees in a Child
Description of Conditions That May Lead to Bowed Legs in a Child
Description of Conditions That May Lead to Knock Knees in a Child
Chapter 61:
In-Toeing and Out-Toeing in a Child
Description of the Symptom
Overview of In-Toeing and Out-Toeing in a Child
Description of Conditions That May Lead to In-Toeing in a Child
Description of Conditions That May Lead to Out-Toeing in a Child
Chapter 62:
Flat Feet in a Child
Description of the Symptom
Overview of Flat Feet in a Child
Description of Conditions That May Lead to Flat Feet in a Child
Chapter 63:
Weakness and Hypotonia in a Child
Description of the Symptom
Overview of Weakness and Hypotonia in a Child
Description of Conditions That May Lead to Weakness and Hypotonia in a Child
Index
