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首页> 外文期刊>Physiotherapy theory and practice >Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report
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Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report

机译：外伤性肘部疼痛的物理治疗师筛选和鉴别诊断：病例报告

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Background and Purpose: Elbow pain can originate from many sources yet have similar signs and symptoms, thereby presenting differential diagnostic challenges. The elbow is commonly injured, thus requiring all clinicians to possess excellent diagnostic skills. Case Description: A 24-year-old woman slipped and fell on her outstretched left hand, experiencing immediate elbow pain. The same day radiographs were deemed negative by her orthopedist, who referred her to physical therapy with the diagnoses of elbow sprain and contusion. Immediately after examining the patient, the physical therapist consulted with the referring orthopedist. The decision to consult was based on: the mechanism of injury, pain severity out of proportion to the referred diagnoses, significantly limited ROM, abnormal joint end feels, exquisite pain with tactile and tuning fork bony palpation, and positive elbow extension test. Outcomes: The treating physical therapist shared the above-noted findings with the orthopedist, who overruled and recommended continuing the original prescription of non-steroidal anti-inflammatory medication and physical therapist treatment for four weeks. The physical therapist's updated plan of care at four weeks noted the patient's continued reports of pain, functional limitations, and disability. A magnetic resonance image (MRI) was then ordered, revealing a radial head fracture. Discussion: A thorough history and examination by the physical therapist led to clustering of signs and symptoms, allowing for the development of a differential diagnosis list which included occult radial head fracture. All clinicians should be prepared to screen for complex conditions. Timely diagnosis and improved outcomes for clinically complex patients are increasingly necessary in contemporary healthcare reimbursement models.
机译：背景与目的：肘部疼痛可能源于许多来源，但具有相似的体征和症状，从而带来了不同的诊断挑战。肘部通常受伤，因此需要所有临床医生具备出色的诊断技能。病例描述：一名24岁妇女滑倒并掉在伸出的左手上，立即遭受肘部疼痛。同一天，她的骨科医生认为X光片是阴性的，她将她转诊至物理疗法，诊断为肘部扭伤和挫伤。对患者进行检查后，理疗师会立即与推荐的骨科医生进行咨询。决定咨询的依据是：损伤的机理，疼痛严重程度与所指诊断不符，明显受限的ROM，关节末端异常感觉，触觉和音叉骨触诊引起的微妙疼痛以及阳性的肘伸试验。结果：物理治疗师与骨科医生分享了上述发现，该医生否决并建议继续使用非甾体类抗炎药和物理治疗师的原始处方治疗四个星期。物理治疗师在四个星期后更新了护理计划，注意到该患者持续出现疼痛，功能受限和残疾的报道。然后订购了磁共振图像（MRI），显示出head骨头骨折。讨论：物理治疗师的详尽历史和检查导致体征和症状聚集，从而形成了包括隐匿性radial骨头骨折在内的鉴别诊断清单。所有临床医生都应做好筛查复杂病情的准备。在当代医疗费用报销模型中，越来越需要针对临床上复杂的患者进行及时诊断和改善结局。

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