Escolar Documentos
Profissional Documentos
Cultura Documentos
in
Orthopaedics
Orthopaedics:
Ortho straight
Paedics children
Musculoskeletal
systems
Bones, joints, muscles,
tendons,
ligaments, peripheral
nerves,
blood vessels.
special tissue:
meniscus, bursa,
Divisions of Orthopaedics
Trauma Surgery
Spine Surgery
Arthroscopy & Sports Medicine
Hand Surgery
Paediatric Orthopaedics
Joint Replacement (Arthroplasty)
Oncology
Trauma - 80 % (worldwide)
Our setup - 95%
Group of Diseases
Congenital & Developmental
abnormalities
Infection & inflammation
Arthritis & rheumatic disorders
Metabolic & Endocrine disorders
Tumors & Lesions that mimic them
Sensory disturbance & muscle weakness
History Taking
Patient story
Doctor constructs history
history systematic, carefully,
patiently compiled & informative
Symptoms
Pain
Stiffness
Swelling
Instability
Deformity
Limp
Altered
Sensation
Loss of function
Precipitating incident
trauma (macrotrauma)
repetitive stress (microtrauma)
is this a work related injury?
is there a lawsuit ongoing?
For MVAs
driver/passenger
belted/non-belted
location of impact and severity of crash
(required jaws of life, if anyone died in the
crash, thrown from the car, etc)
speed at impact
position of the patient and the limb in
question at impact
Onset
Duration
Character
Course
Aggravating and relieving factors
Location
Radition
Associated symptoms
Associated Symptoms
Clicking
Snapping
Catching
Locking
Sensation of giving way (including
prior falls or dislocations)
Swelling
Weakness
Temporality or Timing
Red flags
Pain
Most Common complain
Grading of pain
I
II
III
IV
V
No pain
Mild, can be ignored
Moderate, requires treatment
Severe, intrusive despite analgesics
Very severe, inhibits virtually all activities
activities
- Degenerative
- Infective, neoplastic
Referred pain:
From
Neck
Shoulder
Shoulder
Elbow
Forearm, hand
Lumbar Spine
LS Spine
Region
Hip
leg
Thigh
To
Arm
Groin
Gluteal
Thigh, knee,
Knee
Autonomic pain:
from autonomic nerves
& accompany peripheral blood
vessels
e.g. after operation
Poorly understood, often doubted
Stiffness
Symptom of joint involvement
Protective mechanism, spasm around joint
Generalized:
Localized:
to particular joint
Swelling
Soft tissue, joint, bone
After trauma, injury or reactive
Rapidly or slowly
Painful or not
Constant or comes and goes
Same size or
Instability
C/O Joint giving way
Deformity
Associated with pain & stiffness
c/o knock knees, bowlegs,
Important: Progressive or not
Impaired function or not
Limp
Abnormal pattern of ambulation
Involved joint, dysfunctional muscle,
Due to deformity
Progressive or not
Altered
Sensation
Loss of function
Trauma Patient
General History
ABC
LOC
Spine, Joints, limbs
Previous history of injury