Screening for Medical Problems in Patients with Upper Extremity Signs and Symptoms
published online 30 November 2009.
Abstract
Narrative review
Hand therapists must be able to identify signs and symptoms of systemic disease that can mimic integumentary, neuromuscular, or musculoskeletal dysfunction evaluated and treated within their scope of practice. Pneumonia, complications of pacemakers, liver disease, kidney stones, ectopic pregnancy, and myocardial ischemia are only a few examples of problems and systemic diseases that can cause shoulder or upper extremity signs or symptoms. A screening model is presented for use by therapists in all practice settings. Information gathered is combined with results from the objective evaluation in making a treatment-versus-referral decision. Knowing the risk factors for various illnesses, diseases, and conditions will help guide the therapist in knowing when to screen for specific problems. Recognizing red flag histories, signs, and symptoms will also alert the therapist to the need for additional questions. Clues to screening and tips for physician referral are offered. Level of Evidence 5.
Department of Physical Therapy, School of Pharmacy and Allied Health Sciences, University of Montana, Missoula, Montana
Medical Multimedia Group, Missoula, Montana
Guardian Oncology and Wellness Center, Missoula, Montana
Correspondence and reprint requests to Catherine C. Goodman, PT, MBA, CBP, Department of Physical Therapy, School of Pharmacy and Allied Health Sciences, University of Montana, 806 Dixon Avenue, Missoula, MT 59801
The materials in these two articles were adapted from Goodman CC, Snyder TE: Differential Diagnosis for Physical Therapists: Screening for Referral, 4/e. Philadelphia, W.B. Saunders (Elsevier), 2007. Used with permission.
The author has received no financial support in the preparation of this article.
ABSTRACT