CLINICAL EVALUATION FOR SINUSITIS: MAKING THE DIAGNOSIS BY HISTORY AND PHYSICAL EXAMINATION

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 253-253
Author(s):  
Allen Adinoff

The authors conclude that general internists, focusing on five clinical findings and their overall clinical impression, can effectively stratify patients with sinus symptoms as having a high, intermediate, or low probability of sinusitis.

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Karthik V. Hariharan ◽  
Michael G. Timko ◽  
Christopher G. Bise ◽  
Meenakshi Sundaram ◽  
Michael J. Schneider

Abstract Objective The objective of this study was to establish the level of inter-examiner reliability for six common cervical manual and physical examination procedures used to assess the cervical spine. Materials: Reliability study that used a convenience sample of 51 patients between the ages of 16–70 years presenting with a chief complaint of neck pain. Two physical therapists independently performed the same series of cervical physical examination procedures on each of the participant. The clinicians were blinded to each other’s findings and the clinical status of the patient. Kappa coefficients (κ) were calculated for levels of agreement between the clinicians for each procedure. Results When assessing for asymmetrical motion, excellent levels of reliability (κ range: 0.88–0.96) were observed for the Bilateral Modified Lateral Shear (asymmetry criterion), Bilateral C2 Spinous Kick (asymmetry criterion) and Flexion-Rotation Tests. When pain provocation was used as the indicator of a positive test during palpation of the cervical facet joints, moderate to substantial levels of reliability (κ range: 0.53–0.76) were observed. When patients were instructed not to provide feedback to the clinicians about pain provocation during facet joint palpation and clinicians relied solely on their qualitative assessment of segmental mobility, the level of reliability was lower (κ range: 0.45–0.53). Due to 100 % prevalence of negative findings, Kappa values could not be calculated for the Sharp-Purser test or the Unilateral C2 Spinous Kick Test. Conclusions Most physical examination procedures examined in this study demonstrated moderate to excellent levels of inter-examiner reliability. Palpation for segmental mobility without pain provocation demonstrated a lower level of reliability compared to palpation for pain provocation. Correlation with clinical findings is necessary to establish validity and the applicability of these procedures in clinical practice.


PEDIATRICS ◽  
1977 ◽  
Vol 59 (5) ◽  
pp. 788-789
Author(s):  
A. Frederick North

Dr. Shiela Mitchell and her distinguished committee recommended in the July 1975 issue that blood pressure measurements should be a regular and routine part of every physical examination of every child over the age of 2. They recommended that any child with a blood pressure over the 95th percentile for age have a fundoscopic examination and at least one repeated blood pressure measurement and clinical evaluation within a few weeks. They stated that repeated examinations and further investigations are indicated if the blood pressure persists at or above the 95th percentile.


Open Medicine ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 358-362
Author(s):  
Hüseyin Özkan ◽  
İbrahim Yanmış ◽  
Mustafa Kürklü ◽  
Ali Şehirlioğlu ◽  
Servet Tunay ◽  
...  

AbstractThe most common injuries reported in the literature regarding the sport of boxing are to the brain, eyes, kidneys and hands. Shoulder injuries have not been fully reported in the literature until recently, as a result we aimed to present our arthroscopic findings in amateur boxers. Ten amateur boxers with complaints of pain in the shoulder region and decreased performance during sportsplay were enrolled. They were evaluated by physical examination, radiology and arthroscopy. There were no clinical findings of instability. One patient was found to have subacromial impingement; six had crepitation at various degrees during shoulder movements. At arthroscopy, all patients had a variety of pathological findings. Five patients had Grade 1, three had Grade 2, and two had Grade 3 chondropathy. Various degrees of fraying of the anterosuperior and posterosuperior regions of the glenoid labrum were noted in all cases. Three patients had superior labrum anterior and posterior lesions, one patient had a posterior labroligamentous lesion, and one had chondral erosion in the anterosuperior portion of the humeral head. In conclusions, although the injury mechanism of the shoulder during boxing is unknown, this study shows that shoulder complaints in boxers should be considered as possible indicators of serious intra-articular lesions.


PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 803-807
Author(s):  
Frederick P. Rivara ◽  
Ruth Ann Parish ◽  
Beth A. Mueller

This study sought to identify clinical predictors of extremity fracture in children with trauma. There were 189 children 1 to 15 years of age with 209 extremity injuries seen during a 9-month period. Gross deformity and point tenderness were the best predictors of upper extremity fracture; these two findings correctly identified 81% of children with fractures and 82% of these without fractures. Gross deformity and pain on motion best predicted lower extremity fracture, with 97% of children with fractures correctly identified. The study showed that physical examination is predictive of fractures in extremity injuries of children, regardless of age. In the absence of the specific physical findings identified by the study, the probability of diagnosing a fracture by roentgenographic findings is low.


2016 ◽  
pp. 502-536
Author(s):  
Devon I. Rubin ◽  
Jasper R. Daube

Clinical neurophysiology testing primarily assesses and characterizes neurological disease. Selection of appropriate studies for the problem of an individual patient requires a careful clinical evaluation to determine possible causes of the patient’s symptoms. The approach to testing can be assisted by deciding which structures are likely to be involved. For example, motor and sensory symptoms are best assessed using the different methods of motor and sensory NCS. Deciding which neurophysiological measures to apply in peripheral disorders is sometimes assisted by applying guideline protocols based on the patient’s clinical findings and what is found during testing. Although a clinical neurophysiological assessment rarely provides evidence for a specific diagnosis, it can provide valuable information about the severity, progression, and prognosis of the disease. This chapter reviews the clinical application of neurophysiological tests, particularly nerve conduction studies and needle EMG, in the assessment of patients with a variety of neuromuscular complaints.


2014 ◽  
Vol 17 (03) ◽  
pp. 1450013
Author(s):  
Martin L. Tanaka ◽  
Allston J. Stubbs ◽  
David C. Holst ◽  
Benjamin L. Long

Acetabular labral tears are a common cause of hip pain, but specific diagnosis can be difficult due to limitations in current physical examination techniques and radiographic imaging. Pelvic dynamics were captured in 18 participants (10 labral tear patients) who performed single leg squats and stance exercises. Comparisons were made between the pathologic and non-pathologic legs of patients and between patients and controls. The analysis of bilateral symmetry showed significant differences in most parameters implying unique patient compensatory dynamics. Bilateral symmetry was found to be significant in detecting differences in movement patterns and may become a useful tool for clinical evaluation.


Foot & Ankle ◽  
1988 ◽  
Vol 8 (5) ◽  
pp. 254-263 ◽  
Author(s):  
F. J. Bejjani ◽  
N. Halpern ◽  
A. Pio ◽  
R. Dominguez ◽  
A. Voloshin ◽  
...  

The flamenco dancer acts on the floor like a drummer. The percussive footwork and vibration patterns created during dancing impose unusual demands on the musculoskeletal system. This study investigated the clinical and biomechanical aspects of this task. Using the electrodynogram and skin-mounted accelerometers, foot pressures as well as hip and knee vibrations were recorded in 10 female dancers after a thorough clinical evaluation. A health questionnaire was also distributed to 29 dancers. Foot pressures and acceleration data reveal the percussive nature of the dance. Some clinical findings, like calluses, are related to pressure distribution. Urogenital disorders, as well as back and neck pain, may be related to the vibrations generated by the flamenco dance form. The hip joint seems to absorb most of the impacts. “Vibration-pressure” diagrams are suggested as a useful tool for evaluating a dancer's biomechanical behavior, as well as the effect of floors and footwear on this behavior.


Author(s):  
Kathleen Joy Khu ◽  
Rajiv Midha

A 22-year-old man presented with a one year history of rightsided shoulder pain, hand weakness and tingling, and purplish discoloration of the upper extremity upon abduction. He had congenital pseudarthrosis of the right clavicle since childhood. Aside from an obvious deformity characterized by asymmetry of the shoulders and a palpable bony depression over the right clavicle, the patient had been previously asymptomatic. Physical examination revealed the musculoskeletal deformities as described, as well as prominent veins over his right shoulder, arm, and chest. With arm elevation, his right arm became dusky and his radial pulse diminished. Neurologically, the patient had no deficits except for mild weakness (Grade 4+/5) of the ulnarinnervated intrinsic muscles of the right hand. The clinical findings were consistent with a combined neurogenic and vascular form of thoracic outlet syndrome.


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