December 2018: Deck the Halls with Differential Diagnosis

What is Differential Diagnosis?:

In the physical therapy setting, differential diagnosis involves comprehensive screening for systemic disease that may mimic musculoskeletal or neuromuscular conditions.

Why PT Should Be Your Go-To For Primary Care:

At Integrative Physiotherapy, we ensure that each patient is given a clear diagnosis and plan of care following their initial evaluation. Our therapists take a thorough, comprehensive history and perform evidence-based special tests to determine this diagnosis. If clinical red flags are suspected and your symptoms are not appropriate for physical therapy services, our team will help direct you to the appropriate healthcare practitioner and coordinate your plan of care. For confirmation of an injury or to rule out a systemic cause of musculoskeletal pain, John and Alex may also order imaging.

Some diagnoses that have been referred out for medical care include:

  • Cardiac distress
  • Kidney Stones/Kidney Infection
  • Multiple Myeloma
  • Lyme Disease
  • Gallstones
  • GERD/Stomach Ulcers

Medical management, along with our holistic treatment approach can get you back to feeling your best FASTER!

Case Example of Differential Dx at IP:

Santa sits a LOT in his sleigh. In this year’s sleigh preparation, he’s occasionally experienced a dull ache in his right shoulder.  Sometimes it wakes him during the night and he notices it when prepping presents or following a big snack of cookies and milk.

After treating it with ibuprofen and seeing his primary care physician, who ordered imaging that came back negative for a shoulder injury, Santa’s symptoms got worse…the pain intensified, he’s started having headaches a couple times a week and he felt pain more often with daily activities.

Santa then called to see Dr. John.

Dr. John got a comprehensive history; asked about Santa’s symptoms (the how, when, where and what), collects range of motion/strength measurements and does evidence-based ‘special tests’. Santa left with a clear diagnosis of cervical stenosis contributing to shoulder pain and headaches as well as gallstones… Santa was sent back to his PCP for medical management of the gallstones.

This story has a happy ending, thanks to the comprehensive differential dx process and after a few weeks of PT, Santa recovered successfully with IP’s patient-specific plan of care to strengthen and provide neuromuscular reeducation for improved posture in both sitting and standing. He was discharged pain free with a plan for how to keep the problem from returning and with appropriate medical management of his gallstones.

Although his symptoms may have indicated a possible shoulder injury, Santa was rehabilitated correctly thanks to differential dx and the IP experience, just in time for the holidays!

IP Exercise: Show Your ‘Presence’

This exercise tests your balance and give your inner ear fluid a workout (as well as your shoulders!). Stand on 2 bosu balls, holding medicine balls in each hand. Arms should be in a goal post position. Close your eyes and shake your head side to side for as long as possible while keeping your balance. Stop in the clinic to “Show Your Presence” this month for a chance to win a month free gym membership!

2018-12-06T15:11:36+00:00

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