nari
06-03-2006, 05:07 AM
I thought it may be interesting to kick start a forum where each poster is invited to discuss down-to-earth clinical diversions.
By that I mean, you have a patient on front of you with a 2 year history of head and neck pain. The origin of the pain is unclear, CTs and XRs are equivocal, no nasty pathology viewed, OA is the diagnosis. The patient is 32 yrs old, fit, fell on his head out of a tree 20 years ago, otherwise no apparent Hx of trauma. It's stuffing up his job as a PT; and he has to give up pleasure cycling due to headache.....drugs help a bit, etc etc. No neurological signs present.
What comes to mind in the first 5 minutes?
What focus are you going to have after having a look at ROM and that stuff?
Which 'system' are you going to 'blame'?
What's the fall out of the tree got to do with anything? If anything?
This is just an example; no answers required.
Bring to the forum an example of clinical and critical thinking you did with a patient (or two) who challenged your reasoning powers.
You did not have to have 'success' with interventions; just a look at processes would be fine.
I / we? would like to know how you deal with such issues.
Preferably, this is not a thread for those who ask questions in order to find out what technique works best for condition XYZ- those questions are impossible to try and answer by proxy. As are meagre histories which have to be extracted by ditchdiggers to find out more......;)
Complex pain profiles (my favourites) are most welcome. but if you have a 67yo with persisting pain after a THR or lami....go for it!
Nari
By that I mean, you have a patient on front of you with a 2 year history of head and neck pain. The origin of the pain is unclear, CTs and XRs are equivocal, no nasty pathology viewed, OA is the diagnosis. The patient is 32 yrs old, fit, fell on his head out of a tree 20 years ago, otherwise no apparent Hx of trauma. It's stuffing up his job as a PT; and he has to give up pleasure cycling due to headache.....drugs help a bit, etc etc. No neurological signs present.
What comes to mind in the first 5 minutes?
What focus are you going to have after having a look at ROM and that stuff?
Which 'system' are you going to 'blame'?
What's the fall out of the tree got to do with anything? If anything?
This is just an example; no answers required.
Bring to the forum an example of clinical and critical thinking you did with a patient (or two) who challenged your reasoning powers.
You did not have to have 'success' with interventions; just a look at processes would be fine.
I / we? would like to know how you deal with such issues.
Preferably, this is not a thread for those who ask questions in order to find out what technique works best for condition XYZ- those questions are impossible to try and answer by proxy. As are meagre histories which have to be extracted by ditchdiggers to find out more......;)
Complex pain profiles (my favourites) are most welcome. but if you have a 67yo with persisting pain after a THR or lami....go for it!
Nari