I was recently on my muculoskeletal placement. As I took over a patient list from the previous student at the facility, I had not done the initial assessment on majority of my patients. One particular patient had presented with anterior knee pain. After several treatment sessions she had been making no progress and in recent visits had complained of lateral hip pain. When reviewing her file, I realised that she had not been assessed for tight ITB, which I found rather odd because we have been taught that decreased length of ITB can be a contributing factor to patellofemoral pain. On assessment, it was found that the patient did infact have a very tight ITB with possible trochanteric bursitis. Treatment consisted of ultrasound over her greater trochanter, and soft tissue massage of her ITB. This had an extremely positive effect of pain and knee ROM.
I felt pleased that we had managed to identify this contributing factor and significantly improve the patients condition. The patient was also very happy with her progress seeings as though previous to this, physiotherapy was not having much of an effect.
Through this situation I have realised the importance of performing a thorough initial assessment in order to determine all the key impairments, and therefore guide treatment. It has shown that for all patients we should perform all necessary objective assessments, even though some of them seem a waste of time because we never know what conclusions we may draw from them.
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2 comments:
This is a very good point you make Brooke. Although in some situations it may be tempting to skip out parts of the objective assessment it is important to include it all, especially if you are not continuing with the care of the patient. It is excellent that you were able to look back through the notes and realise that a vital part had been missed in order to help this patient.
Yeah good call. I found out when i was on my Musculoskeletal placement that it was really important to go through the assessments thoroughly and think about what your really assessing as then you won't miss the clues that are contributing to the pathology.
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