Hi, Please, do not use Mayo clinic or internet source as reference. Please, use peered reviewed articles and/or Textbooks. Thanks a lot! Discussion: Assessing Musculoskeletal Pain The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams. In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting. To prepare: · Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. · Review the following case studies: With regard to the case study, you were assigned: · Review this week's Learning Resources and consider the insights they provide about the case study. · Consider what history would be necessary to collect from the patient in the case study you were assigned. · Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient's condition. How would the results be used to make a diagnosis? · Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Note: Before you submit your initial post, replace the subject line ("Discussion - Week 8") with "Review of Case Study ___." Fill in the blank with the number of the case study you were assigned. By Day 3 of Week 8 Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient's differential diagnosis, and justify why you selected each.  Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the "Post to Discussion Question" link, and then select "Create Thread" to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! The Case study: Knee Pain Photo Credit: University of Virginia. (n.d.). N ...

1. Hi,
Please, do not use Mayo clinic or internet source as reference.
Please, use peered reviewed articles and/or Textbooks.
Thanks a lot!
Discussion: Assessing Musculoskeletal Pain
The body is constantly sending signals about its health. One of
the most easily recognized signals is pain. Musculoskeletal
conditions comprise one of the leading causes of severe long-
term pain in patients. The musculoskeletal system is an
elaborate system of interconnected levers that provides the body
with support and mobility. Because of the interconnectedness of
the musculoskeletal system, identifying the causes of pain can
be challenging. Accurately interpreting the cause of
musculoskeletal pain requires an assessment process informed
by patient history and physical exams.
In this Discussion, you will consider case studies that describe
abnormal findings in patients seen in a clinical setting.
To prepare:
· Your Discussion post should be in the Episodic/Focused SOAP
Note format rather than the traditional narrative style
Discussion posting format. Refer to Chapter 2 of the Sullivan
text and the Episodic/Focused SOAP Template in the Week 5
Learning Resources for guidance. Remember that all
Episodic/Focused SOAP notes have specific data included in
every patient case.
· Review the following case studies:

2. With regard to the case study, you were assigned:
· Review this week's Learning Resources and consider the
insights they provide about the case study.
· Consider what history would be necessary to collect from the
patient in the case study you were assigned.
· Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient's
condition. How would the results be used to make a diagnosis?
· Identify at least five possible conditions that may be
considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject
line ("Discussion - Week 8") with "Review of Case Study ___."
Fill in the blank with the number of the case study you were
assigned.
By Day 3 of Week 8
Post an episodic/focused note about the patient in the case study
to which you were assigned using the episodic/focused note
template provided in the Week 5 resources. Provide evidence
from the literature to support diagnostic tests that would be
appropriate for each case. List five different possible conditions
for the patient's differential diagnosis, and justify why you
selected each.
Note: For this Discussion, you are required to complete your
initial post before you will be able to view and respond to your
colleagues’ postings. Begin by clicking on the "Post to
Discussion Question" link, and then select "Create Thread" to
complete your initial post. Remember, once you click on
Submit, you cannot delete or edit your own posts, and you
cannot post anonymously. Please check your post carefully
before clicking on Submit!
The Case study: Knee Pain

3. Photo Credit: University of Virginia. (n.d.). Normal Knee
Anatomy [Photograph]. Retrieved from http://www.med-
ed.virginia.edu/courses/rad/ext/7knee/01anatomy.html. Used
with permission of University of Virginia.
A 15-year-old male reports dull pain in both knees. Sometimes
one or both knees click, and the patient describes a catching
sensation under the patella. In determining the causes of the
knee pain, what additional history do you need? What categories
can you use to differentiate knee pain? What are your specific
differential diagnoses for knee pain? What physical examination
will you perform? What anatomic structures are you assessing
as part of the physical examination? What special maneuvers
will you perform?
With regard to the case study, you were assigned:
· Review this week's Learning Resources and consider the
insights they provide about the case study.
· Consider what history would be necessary to collect from the
patient in the case study you were assigned.
· Consider what physical exams and diagnostic tests would be
appropriate to gather more information about the patient's
condition. How would the results be used to make a diagnosis?
· Identify at least five possible conditions that may be
considered in a differential diagnosis for the patient.
Note: Before you submit your initial post, replace the subject
line ("Discussion - Week 8") with "Review of Case Study ___."
Fill in the blank with the number of the case study you were
assigned.
By Day 3 of Week 8
Post an episodic/focused note about the patient in the case study
to which you were assigned using the episodic/focused note
template provided in the Week 5 resources. Provide evidence
from the literature to support diagnostic tests that would be
appropriate for each case. List five different possible conditions
for the patient's differential diagnosis, and justify why you

4. selected each.
Note: For this Discussion, you are required to complete your
initial post before you will be able to view and respond to your
colleagues’ postings. Begin by clicking on the "Post to
Discussion Question" link, and then select "Create Thread" to
complete your initial post. Remember, once you click on
Submit, you cannot delete or edit your own posts, and you
cannot post anonymously. Please check your post carefully
before clicking on Submit!
Read a selection of your colleagues' responses.
Rubric Detail
Excellent
Good
Fair
Poor
Main Posting
45 (45%) - 50 (50%)
"Answers all parts of the Discussion question(s) with reflective
critical analysis and synthesis of knowledge gained from the
course readings for the module and current credible sources.
Supported by at least three current, credible sources. Written
clearly and concisely with no grammatical or spelling errors and
fully adheres to current APA manual writing rules and style.
40 (40%) - 44 (44%)
"Responds to the Discussion question(s) and is reflective with

5. critical analysis and synthesis of knowledge gained from the
course readings for the module. At least 75% of post has
exceptional depth and breadth. Supported by at least three
credible sources. Written clearly and concisely with one or no
grammatical or spelling errors and fully adheres to current APA
manual writing rules and style.
35 (35%) - 39 (39%)
"Responds to some of the Discussion question(s). One or two
criteria are not addressed or are superficially addressed. Is
somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course
readings for the module. Post is cited with two credible sources.
Written somewhat concisely; may contain more than two
spelling or grammatical errors. Contains some APA formatting
errors.
0 (0%) - 34 (34%)
"Does not respond to the Discussion question(s) adequately.
Lacks depth or superficially addresses criteria. Lacks reflection
and critical analysis and synthesis. Does not represent
knowledge gained from the course readings for the module.
Contains only one or no credible sources. Not written clearly or
concisely. Contains more than two spelling or grammatical
errors. Does not adhere to current APA manual writing rules
and style.
Main Post: Timeliness
10 (10%) - 10 (10%)
Posts main post by Day 3.
0 (0%) - 0 (0%)
N/A
0 (0%) - 0 (0%)
N/A
0 (0%) - 0 (0%)
Does not post main post by Day 3.
First Response
17 (17%) - 18 (18%)
"Response exhibits synthesis, critical thinking, and application

6. to practice settings. Provides clear, concise opinions and ideas
that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of Learning
Objectives. Communication is professional and respectful to
colleagues. Responses to faculty questions are fully answered,
if posed. Response is effectively written in standard, edited
English.
15 (15%) - 16 (16%)
"Response exhibits critical thinking and application to practice
settings. Communication is professional and respectful to
colleagues. Responses to faculty questions are answered, if
posed. Provides clear, concise opinions and ideas that are
supported by two or more credible sources. Response is
effectively written in standard, edited English.
13 (13%) - 14 (14%)
"Response is on topic and may have some depth. Responses
posted in the Discussion may lack effective professional
communication. Responses to faculty questions are somewhat
answered, if posed. Response may lack clear, concise opinions
and ideas, and a few or no credible sources are cited.
0 (0%) - 12 (12%)
"Response may not be on topic and lacks depth. Responses
posted in the Discussion lack effective professional
communication. Responses to faculty questions are missing. No
credible sources are cited.
Second Response
16 (16%) - 17 (17%)
"Response exhibits synthesis, critical thinking, and application
to practice settings. Provides clear, concise opinions and ideas
that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of Learning
Objectives. Communication is professional and respectful to
colleagues. Responses to faculty questions are fully answered,
if posed. Response is effectively written in standard, edited
English.
14 (14%) - 15 (15%)

7. "Response exhibits critical thinking and application to practice
settings. Communication is professional and respectful to
colleagues. Responses to faculty questions are answered, if
posed. Provides clear, concise opinions and ideas that are
supported by two or more credible sources. Response is
effectively written in standard, edited English.
12 (12%) - 13 (13%)
"Response is on topic and may have some depth. Responses
posted in the Discussion may lack effective professional
communication. Responses to faculty questions are somewhat
answered, if posed. Response may lack clear, concise opinions
and ideas, and a few or no credible sources are cited.
0 (0%) - 11 (11%)
"Response may not be on topic and lacks depth. Responses
posted in the Discussion lack effective professional
communication. Responses to faculty questions are missing. No
credible sources are cited.
Participation
5 (5%) - 5 (5%)
Meets requirements for participation by posting on three
different days.
0 (0%) - 0 (0%)
N/A
0 (0%) - 0 (0%)
N/A
0 (0%) - 0 (0%)
Does not meet requirements for participation by posting on
three different days.
Total Points: 100
Episodic/Focused SOAP Note Template
Patient Information:
Initials, Age, Sex, Race
S.

8. CC (chief complaint) a BRIEF statement identifying why the
patient is here - in the patient’s own words - for instance
"headache", NOT "bad headache for 3 days”.
HPI: This is the symptom analysis section of your note.
Thorough documentation in this section is essential for patient
care, coding, and billing analysis. Paint a picture of what is
wrong with the patient. Use LOCATES Mnemonic to complete
your HPI. You need to start EVERY HPI with age, race, and
gender (e.g., 34-year-old AA male). You must include the seven
attributes of each principal symptom in paragraph form not a
list. If the CC was “headache”, the LOCATES for the HPI might
look like the following example:
Location: head
Onset: 3 days ago
Character: pounding, pressure around the eyes and temples
Associated signs and symptoms: nausea, vomiting, photophobia,
phonophobia
Timing: after being on the computer all day at work
Exacerbating/ relieving factors: light bothers eyes, Aleve makes
it tolerable but not completely better
Severity: 7/10 pain scale
Current Medications: include dosage, frequency, length of time
used and reason for use; also include OTC or homeopathic
products.
Allergies: include medication, food, and environmental allergies
separately (a description of what the allergy is ie angioedema,
anaphylaxis, etc. This will help determine a true reaction vs
intolerance).
PMHx: include immunization status (note date of last tetanus
for all adults), past major illnesses and surgeries. Depending on
the CC, more info is sometimes needed
Soc Hx: include occupation and major hobbies, family status,
tobacco & alcohol use (previous and current use), any other
pertinent data. Always add some health promo question here -
such as whether they use seat belts all the time or whether they

9. have working smoke detectors in the house, living environment,
text/cell phone use while driving, and support system.
Fam Hx: illnesses with possible genetic predisposition,
contagious or chronic illnesses. Reason for death of any
deceased first degree relatives should be included. Include
parents, grandparents, siblings, and children. Include
grandchildren if pertinent.
ROS: cover all body systems that may help you include or rule
out a differential diagnosis You should list each system as
follows: General:Head: EENT: etc. You should list these in
bullet format and document the systems in order from head to
toe.
Example of Complete ROS:
GENERAL: Denies weight loss, fever, chills, weakness or
fatigue.
HEENT: Eyes: Denies visual loss, blurred vision, double vision
or yellow sclerae. Ears, Nose, Throat: Denies hearing loss,
sneezing, congestion, runny nose or sore throat.
SKIN: Denies rash or itching.
CARDIOVASCULAR: Denies chest pain, chest pressure or
chest discomfort. No palpitations or edema.
RESPIRATORY: Denies shortness of breath, cough or sputum.
GASTROINTESTINAL: Denies anorexia, nausea, vomiting or
diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination. Pregnancy. Last
menstrual period, MM/DD/YYYY.
NEUROLOGICAL: Denies headache, dizziness, syncope,
paralysis, ataxia, numbness or tingling in the extremities. No
change in bowel or bladder control.
MUSCULOSKELETAL: Denies muscle, back pain, joint pain
or stiffness.
HEMATOLOGIC: Denies anemia, bleeding or bruising.
LYMPHATICS: Denies enlarged nodes. No history of
splenectomy.
PSYCHIATRIC: Denies history of depression or anxiety.
ENDOCRINOLOGIC: Denies reports of sweating, cold or heat

10. intolerance. No polyuria or polydipsia.
ALLERGIES: Denies history of asthma, hives, eczema or
rhinitis.
O.
Physical exam: From head-to-toe, include what you see, hear,
and feel when doing your physical exam. You only need to
examine the systems that are pertinent to the CC, HPI, and
History. Do not use “WNL” or “normal.” You must describe
what you see. Always document in head to toe format i.e.
General: Head: EENT: etc.
Diagnostic results: Include any labs, x-rays, or other diagnostics
that are needed to develop the differential diagnoses (support
with evidenced and guidelines)
A.
Differential Diagnoses (list a minimum of 3 differential
diagnoses).Your primary or presumptive diagnosis should be at
the top of the list. For each diagnosis, provide supportive
documentation with evidence based guidelines.
P.
This section is not required for the assignments in this course
(NURS 6512) but will be required for future courses.
References
You are required to include at least three evidence based peer -
reviewed journal articles or evidenced based guidelines which
relates to this case to support your diagnostics and differentials
diagnoses. Be sure to use correct APA 7th edition formatting.
© 2021 Walden University, LLC
Page 1 of 3