How to present a case

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How to present a case

  1. 1. HOW TO PRESENT A CASE Dr. G. V. S. MoorthyProfessor & HOD of Orthopaedics Osmania Medical College
  2. 2. ACCENT AND ATTITUDE
  3. 3. ACCENT AND ATTITUDE
  4. 4. ACCENT AND ATTITUDE
  5. 5. ACCENT AND ATTITUDE
  6. 6. SPOKEN ENGLISH
  7. 7. SPOKEN ENGLISH - ABC
  8. 8. SPOKEN ENGLISH - CHINESE
  9. 9. SPOKEN ENGLISH - BUTTLER
  10. 10. INDIAN ENGLISH North Indian East West Indian Indian South Indian
  11. 11. COMMUNICABLE ENGLISH• CLARITY• SPACING• FLUENCY AND FLOW• AUDIBLE• SIMPLE WORDS• SINGLE SENTENCES• GRAMMATIC
  12. 12. GADGETS
  13. 13. GADGETS
  14. 14. BROAD HEADINGS• HISTORY• GENERAL EXAMINATION• REGIONAL EXAMINATION• PROVISIONAL DIAGNOSIS• INVESTIGATIONS• DEFINITIVE DIAGNOSIS• MANAGEMENT• PROGNOSIS
  15. 15. HISTORY• HISTORY OF PRESENT ILLNESS• PAST HISTORY• PERSONAL HISTORY• FAMILY HISTORY• TREATMENT HISTORY• MENSTRUAL HISTORY• BIRTH HISTORY• RETROSPECTIVE HISTORY
  16. 16. COMPLAINTS & PRESENT ILLNESS• PAIN• SWELLING• DEFORMITY• DISABILITY• SHORTENING• LOSS OF FUNCTION• FEVER• TRAUMA
  17. 17. PAIN• SITE – PRESENT AND IN PAST• RADIATION• CHARACTER• SEVERITY• TIME COURSE• AGGREVATING, RELEIVING FACTORS• ASSOCIATED SYMPTOMS
  18. 18. PROGRESS OF SYMPTOMS• PROGRESSIVE DETERIORATION• PROGRESSIVE BETTERMENT• AGGREVATION AND RELEIF• REMISSIONS AND RELAPSES• MODIFICATION WITH MEDICATION ETC.• DIURNAL AND SEASONAL VARIATION• REST PAIN
  19. 19. GENERAL EXAMINATION• PERIPHERAL PULSES• PERIPHERAL NERVES• SKIN PATCHES AND PIGMENTATION• LYMPHADENOPATHY• SOFT TISSUE LAXITY, SKIN TURGOR• ORGANOMEGALY• BUILT, ANAEMIA, JAUNDICE. CLUBBING ETC.
  20. 20. REGIONAL EXAMINATION• GAIT• ATTITUDE AND DEFORMITY• INSPECTION• PALPATION• (PERCUSSION AND AUSCULTATION)• MOVEMENTS• MEASUREMENTS• SPECIAL TESTS• LYMPH NODES, DISTAL N.V. STATUS• SPINE AND OTHER JOINTS
  21. 21. GAITOBSERVED AS THE PATIENT WALKS IN TO AVOID PATIENT BIASS / RECHECKED AT THE END OF EXAMINATION• STABLE, PAINLESS, ASYMMETRIC• STABLE, PAINFUL• UNSTABLE, PAINLESS• UNSTABLE AND PAINFUL
  22. 22. GAIT – SPECIFIC TYPES• TRENDLENBERG GAIT (PAINLESS, UNSTABLE)• SHORT LIMB GAIT (PAINLESS, STABLE)• ANTALGIC GAIT (PAINFUL, STABLE)• NON WEIGHT BEARING ( PAINFUL, UNSTABLE)• HIGH STEPPING GAIT ( FOOT DROP )• WADDLING GAIT (BILATERAL PAINLESS,UNSTABLE)• STIFF HIP GAIT (PAINLESS, STABLE)• CIRCUMDUCTION GAIT (SPASTIC LOWER LIMB)• SCISCORING GAIT (SPASTICITY BOTH LEGS)• MINCING IN CHOREA, FESTINANT IN PARKINSONISM
  23. 23. INSPECTIONSEE ALL SIDES:• HOLLOWS• SWELLINGS• BONY LAND MARKS• MUSCLE SPASM AND WASTING• SKIN CREASES, SCARS, SINUSES• VESSELS
  24. 24. PALPATION• TEMPERATURE• TENDERNESS – DIRECT / INDIRECT - BONE, JOINT, TENDON, LIGAMENT, CARTILAGE• NORMAL BONY LAND MARKS• ABNORMAL MASSES• SWELLING – ARTICULAR / EXTRA ARTICULAR – FLUID / SOLID• VESSELS, SKIN, SOFT TISSUE, MUSCLE TONE
  25. 25. MOVEMENTS• FIXED DEFORMITIES• MOVEMENTS – ACTIVE / PASSIVE• MOVEMENTS – POSITION OF LIMB• CREPITUS, PAIN• DEVIATIONS – AXIS DEVIATION• ABNORMAL MOVEMENTS / INSTABILITY• TRANSMITTED MOVEMENTS
  26. 26. MEASUREMENTS• LENGTH• BREADTH• CIRCUMFERENCE• APPARENT AND REAL• LINES• ANGLES
  27. 27. THANK YOU• KNOWLEDGE MAKES A MAN WISE,• PRACTICE MAKES HIM PERFECT,• RESULTS MAKE ALL REJOICE!

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