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Hawkins Kennedy Test For Shoulder Impingement

October 15, 2011 By Leave a Comment

Hawkins and Kennedy test is of shoulder impingement. It identifies impingement of greater tuberosity against the coraco- humeral ligament, trapping and structures which intervene.

Position

Sitting

Test

With patient sitting, the the arm and elbow is flexed at to 90°, supported by the examiner. The examiner then stabilizes proximal to the elbow with their outside hand and with the other holds just proximal to the patient’s wrist. It is then quickly move the arm into internal rotation.

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Clinical Photograph of Limited Abduction Demonstrated By Crosslegged Sitting

October 9, 2011 By Leave a Comment

Crosslegged sitting is a very common posture in Asian countries. It is also a very good method to assess the hip movements like flexion and abduction.

Limitation of abduction is demonstrated by following clinical photograph.

limited abduction reulting in incomplete crosslegged sitting

We commonly use this method in busy OPD hours to quickly screen the patients

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Clinical Photogrpah Demonstrating Stiffness of Elbow

September 16, 2011 By Leave a Comment

An example to show stiffness of left elbow. Note the full flexion in right elbow.

Limitation of elbow movements

Demonstarion of Limited Motion of Left elbow

The left elbow is comparatively less flexed showing stiffness.

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Evaluation Of A Patient Of Idiopathic Adolescent Scoliosis

May 20, 2011 By Leave a Comment

The evaluation begins with a thorough history as is the dictum in medical evaluation procedures and it is followed by complete physical examination and neurological examination. This is followed by radiographic evaluation

In physical examination, after the general physical examination, the spine is examined and characteristics of the deformity are recorded.

The height of the patient while standing and while sitting should be measured and recorded. These measurements can be compared with future measurements in follow up to determine changes in the patient’s total height and whether any change is caused by growth of the lower extremities or by an increase or a decrease in the height of the trunk.

A detailed physical and neurological examination would help to rule out any neoplasm or a neurological disorder as the cause of scoliosis. [Read more...]

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What Is A Neurogenic Shock?

July 2, 2009 By Leave a Comment

Neurogenic shock is a type of shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls.

This results in loss of background sympathetic stimulation, which is responsible for maintenence of tone of blood vessels. As a result of loss of vascular tone, the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance and decreased blood pressure. [Read more...]

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Approach To The Patient With Hip Pain

February 21, 2008 By 10 Comments

Hip pain is quite a cause for concern when it occurs. A systematic approach to the hip would help to delineate the plausible causes.

The first thing that is done for examining the hip is observation of the gait. This is done the moment patient comes in without making him cautious.

A careful clinical history would narrow the possibilities of diagnoses which are then furthe r narrowed in examination in usual sequence. [Read more...]

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Approach To Patient With Knee Pain

February 19, 2008 By Leave a Comment

Knee joint is an important jpoint for movement and transmitting body weight to the ground. It is very frequent for this joint to get affected by problems. A careful history should highlight the chronology of the knee complaint. A probable list of of causes should be explored in history. Any predisposing condition like trauma, or medications that might underlie the complaint should be asked.

History is followed by observation of the patient’s gait.

The knee should be carefully inspected in the upright (weight-bearing) and prone positions for

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Approach To The Patient With Shoulder Pain

February 18, 2008 By Leave a Comment

Shoulder pain can originate from many causes. Therefore, during the evaluation of shoulder pain, one should carefully note any history of trauma, infection, iniflammatory disease, occupational hazards, or previous cervical disease. It is important to know whether shoulder pain is continuous or is on specific movements only.

Apart from originating from shoulder itself, shoulder pain frequently is referred from the cervical spine and intrathoracic lesions i.e. Pancoast tumor, gallbladder, hepatic, or diaphragmatic disease. [Read more...]

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Approach To The Patient With Hand Pain

February 16, 2008 By Leave a Comment

Focal or unilateral hand pain may result from following causes

  • Trauma
  • Overuse
  • Infection
  • Reactive Arthritis
  • Crystal induced arthritis
  • Tumors

By contrast, bilateral hand complaints suggest osteoarthritis or a systemic or inflammatory or immune etiology.

Patterns of joint involvement are highly suggestive of certain disorders. [Read more...]

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Approach To Examination of An Elderly Patient With Muculoskeletal Disorders

February 16, 2008 By Leave a Comment

Elderly or geriatric patients need special evaluation. Musculoskeletal disorders in elderly patients are often not diagnosed because the signs and symptoms may be insidious or chronic in these patients.The evaluation follows the same pattern of history, examination and investigation but needs to take few things into account and perform additional inquiries to exclude common geriatric musculoskeletal disorders [Read more...]

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