Category: Orthopedics
Keywords: joint, documentation, physical examination (PubMed Search)
Posted: 10/9/2010 by Brian Corwell, MD
(Updated: 11/1/2024)
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Previous pearls have described tips for smart and safe documentation of typical ED complaints such as chest pain. Properly assessing and documenting orthopedic complaints is likewise very important. No evaluation or chart is complete if it does not include include the following 7 components:
The joint above
The joint below
Motor
Sensory
Vascular
Skin
Compartments
The joint above/below is important in cases of shoulder and hip pain actually being radicular pain (from the neck and back respectively). Also, hip pain from trauma may be due to a femur fracture for example.
For motor and sensory evaluation, test the most distal isolated innervation of a particular nerve (L5 - great toe dorsiflexion for example).
Note distal pulses and check ABIs for injuries with potential subtle vascular findings.
Note intact skin especially in cases where the joint will be covered by a splint.
Note "soft" compartments especially in cases of forearm and lower leg fractures.