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PM & R : the Journal of Injury,... Jan 2013Rotator cuff tears are the leading cause of shoulder pain and shoulder-related disability and account for 4.5 million physician visits in the United States annually. A... (Review)
Review
Rotator cuff tears are the leading cause of shoulder pain and shoulder-related disability and account for 4.5 million physician visits in the United States annually. A careful history and structured physical examination are often sufficient for diagnosing rotator cuff disorders. We are not aware of a clinical review article that presents a structured physical examination protocol of the rotator cuff for the interested clinician. To fill this void, we present a physical examination protocol developed on the basis of review of prior literature and our clinical experience from dedicated shoulder practices. Our protocol includes range of motion testing by using a goniometer, strength testing by using a dynamometer, and select special tests. Among the many tests for rotator cuff disorders that have been described, we chose ones that have been more thoroughly assessed for sensitivity and specificity. This protocol can be used to isolate the specific rotator cuff tendon involved. The protocol can typically be completed in 15 minutes. We also discuss the clinical implications and limitations of the physical examination maneuvers described in our protocol. This protocol is thorough yet time efficient for a busy clinical practice. It is useful in the diagnosis of rotator cuff tears, impingement syndrome, and biceps pathology.
Topics: Humans; Physical Examination; Rotator Cuff; Shoulder Impingement Syndrome
PubMed: 23332909
DOI: 10.1016/j.pmrj.2012.08.019 -
BMJ (Clinical Research Ed.) Mar 1991
Topics: Brazil; Education, Medical, Undergraduate; Medical History Taking; Physical Examination
PubMed: 2012883
DOI: 10.1136/bmj.302.6777.645 -
MedEdPORTAL : the Journal of Teaching... 2022The majority of medical schools utilize peer physical examination (PPE) as a teaching tool. In recent years, trauma-informed care (TIC) has been applied as a framework...
INTRODUCTION
The majority of medical schools utilize peer physical examination (PPE) as a teaching tool. In recent years, trauma-informed care (TIC) has been applied as a framework for physical examination to prevent patient retraumatization. Although medical students experience rates of trauma comparable to those of the general population, trauma-informed principles have not been integrated into PPE curricula.
METHODS
We created a novel trauma-informed PPE (TIPPE) curriculum grounded in core principles of TIC for first-year medical students. Perceptions of safety, trust, and autonomy in PPE practice were compared between the 152 students participating in the TIPPE curriculum and a control group from the prior year.
RESULTS
Twenty-nine percent of the 42 first-year medical student respondents in our sample endorsed a prior diagnosis with a mental health condition, and 33% endorsed a trauma history. Approximately 5% of student respondents ( = 5) in the interventional and control groups reported that PPE triggered recall of a prior traumatic event. Following participation in the TIPPE curriculum, familiarity with TIC principles rose significantly, although overall rating of the experience did not change. Thematic analysis of qualitative data highlighted students' desire for earlier and increased inclusion of TIC principles in the curriculum.
DISCUSSION
Our results demonstrate the necessity of adapting the standard PPE model in medical education in response to the real risk of student retraumatization. In sharing our curriculum, associated resources, and student-derived suggestions for further improvement, we provide a blueprint for other institutions seeking to train trauma-informed clinicians.
Topics: Curriculum; Humans; Peer Group; Physical Examination; Schools, Medical; Students, Medical
PubMed: 36118916
DOI: 10.15766/mep_2374-8265.11273 -
The Veterinary Clinics of North... Dec 2015Diagnostic imaging can substantially augment physical examination findings in neonatal foals. Used in combination with radiography or as a stand-alone imaging modality,... (Review)
Review
Diagnostic imaging can substantially augment physical examination findings in neonatal foals. Used in combination with radiography or as a stand-alone imaging modality, ultrasound evaluation of the thoracic and abdominal body cavities can be a high-yield diagnostic undertaking. Many of the conditions that afflict neonatal foals are highly amenable to sonographic interrogation, including pneumonia and other changes in the lungs associated with sepsis, systemic inflammatory response syndrome, multiple organ dysfunction, and prematurity; colic arising from medical and surgical causes; and urinary tract disorders. Sonographic imaging is not affected by intracavitary fluid accumulation and reveals abnormalities of soft tissue and bony origin.
Topics: Abdomen; Animals; Animals, Newborn; Horse Diseases; Horses; Physical Examination; Thorax
PubMed: 26612746
DOI: 10.1016/j.cveq.2015.09.004 -
Postgraduate Medicine Jan 2020: Little is known about patient preference regarding the physical exam in non-urgent primary care settings.: To determine the differences between a patient's...
: Little is known about patient preference regarding the physical exam in non-urgent primary care settings.: To determine the differences between a patient's expectations of the physical exam and the actual components of the physical examination performed during a non-urgent visit.: A total of 452 surveys administered in the waiting room of a VA primary care clinic in West Haven, CT.: The response rate was 91.6% (n = 414). For 15 of 16 maneuvers on the survey, more respondents believed a reasonable provider should conduct it than received it at their annual physical exam; for 7 of them (breast, axillary, rectal, pelvic, total body skin exam, electrocardiogram, and stress test), over twice as many respondents believed they should be done than received them. There was an association between a patient's perception of their primary care provider and the number of maneuvers recalled at their annual exam (P < 0.001), and a gap in the number of maneuvers expected from a reasonable provider by nonwhite and white patients (P < 0.001).: Convenience sample, response bias (healthy patients are more likely to respond) and recall bias.: Patient perception of their primary care provider is strongly associated with the number of maneuvers recalled during an annual physical. Furthermore, the number of maneuvers expected by a patient is influenced by race, with nonwhite patients desiring more. This suggests the need for further research on the role of race in the expectations of healthcare providers.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Patient Preference; Physical Examination; Primary Health Care; Surveys and Questionnaires; Young Adult
PubMed: 31928276
DOI: 10.1080/00325481.2020.1713618 -
BMJ (Clinical Research Ed.) Jun 2007
Review
Topics: Diagnosis, Differential; Fatigue; Humans; Medical History Taking; Physical Examination; Referral and Consultation
PubMed: 17556480
DOI: 10.1136/bmj.39182.615405.94 -
BMJ (Clinical Research Ed.) Nov 2005
Review
Topics: Behavior Therapy; Humans; Life Style; Male; Middle Aged; Physical Examination; Snoring
PubMed: 16269493
DOI: 10.1136/bmj.331.7524.1063 -
Cleveland Clinic Journal of Medicine Jun 2018
Topics: Humans; Neurologic Examination; Physical Examination
PubMed: 29883304
DOI: 10.3949/ccjm.85a.17110 -
Journal of General Internal Medicine Aug 2010
Topics: Education, Medical; Humans; Physical Examination; Schools, Medical; Students, Medical
PubMed: 20502975
DOI: 10.1007/s11606-010-1400-3 -
Current Sports Medicine Reports 2014Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training... (Review)
Review
Setting standards for medically based running analyses is necessary to ensure that runners receive a high-quality service from practitioners. Medical and training history, physical and functional tests, and motion analysis of running at self-selected and faster speeds are key features of a comprehensive analysis. Self-reported history and movement symmetry are critical factors that require follow-up therapy or long-term management. Pain or injury is typically the result of a functional deficit above or below the site along the kinematic chain.
Topics: Athletic Injuries; Biomechanical Phenomena; Humans; Physical Endurance; Physical Examination; Running
PubMed: 25014394
DOI: 10.1249/JSR.0000000000000071