Tuesday, March 4, 2008
difficult subjective assessment
just a little question. i had a patient in my last week of musculo placement that was referred after a fall with an MRI showing a meniscal tear. As a result, i had the expectation that it would be a fairly straightforward case. However, upon subjective questioning, i realised that she had pain in 3 different regions of her knee which radiated up and down her thigh and shin and also pain in her ankle, 2nd toe and pins and needles which were related to her knee pain. she had 2 different falls which predisposed her to different structures in her knee being injured. besides, she also presented with wrist and elbow pain as well as occasional stiffness in her neck, shoulder and even back. the entire subjective assessment took me about 35 minutes to complete even though i just focussed on the lower limbs! my question is then how do we balance getting a comprehensive subjective and making sure we don't eat up too much of the patients time? what a dilemma...
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