11) Musculoskeletal Elimination & Diagnosis

• guide the intervention

• gives pt a label

• a payer can see where you are

• critical to show evidence

why bother w diagnosis?

medical world diagnosis

• pathoanatomic (pathology & tissue/region/organ)

• nature of the pathology drives the care/prescription (pill)

PT world diagnosis

• concept of movement diagnosis

• impairment-based drives the prescription

• relate to limitations in functional activity

medical world

• pathoanatomy

• often directs general treatment approach and informs prognosis

PT world

• impairments

• usually dictates what we actually do w a pt

cyriax (British PT)

who came up with orthopedic medicine:

• Diagnosis by selective tension

• Identify the tissue with the “lesion

• Reproduce chief complaint (CC) symptoms by applying tension

medical approach

cyriax approach to examination is more of a

comparable sign

• Maitland

• Reproduction of the patient’s chief complaint with a movement, position, or test

contractile

• muscle

• tendon

inert

lacking the ability or strength to move

inert

• capsule

• ligament

• menisci

• bone

• bursa

pattern = whole joint involved not an isolated tissue