OSCE Musculoskeletal history taking PDF

Preview

Summary

Diseased Systems: Central Nervous And Musculo-Skeletal Systems MPH322...

Description

Musculoskeletal Problem Hands, ankle, knee, shoulder

History taking

P O

P

Q R S

T U

-Presenting complain: what seems to be the problem? -When did the injury occur? -How did it occur? -Does it affect your daily activities? -Are you able to bear weight on it? -Pain on movement? -Precipitating factors? -Previous injuries to that joint? -Quality of pain -Any clicking, locking, or giving away of joint? -Relieving factors -Radiation of pain? -Severity of pain on scale of 1-10 -Any swelling? -How quickly did the swelling occur? -Is the pain on or off? Or is it continuous? -Any concerns?

Management Advice: PRICE, HARM, Analgesia, Gentle mobilization, Recovery period P R

-Protect the injured part from further injury -Rest the affected joint/muscle for 48-72 hrs following the injury -You can use crutches for an ankle, knee, or leg injury -Use sling if wrist/hand -Apply ice ASAP after injury. This limits pain and inflammation -Wrap the ice in a damp towel and apply it to the injured area for 15-20 mins. NOT more than 30 mins -This should be done every 2-3 hrs during the day for the first 2-3 days after the injury -Compression with bandage will limit swelling -Remove bandage before going to sleep -Remove it completely alter 48 hours so the joint can freely move -Elevation limits and reduces swelling -Ankle/Knee  Keep foot up on a chair to at least hip level when you are sitting -Hand/Wrist  use a sling with your hand and wrist higher than your elbow

I

C

E

Heat (avoid for 72 hrs after injury) Alcohol (avoid for 72 hrs after injury) Running (avoid for 72 hrs after injury) Massage (avoid for 72 hrs after injury)

-Heat should be avoided for 72 hrs after injury -No hot baths, saunas, or heat packs -Alcohol increases bleeding and swelling -Alcohol decreases healing -Running or any other form of exercise may cause further damage -Massage may increase bleeding and swelling.

Analgesia 

Paracetamol or NSAID 48 hrs after injury

Recovery period  

Within first week you should feel better However, it may take up to 6 weeks to heal

Mobilization 

Gentle mobilization so that the joint is not fixed all the time...