Inspection-palpation-percussion-auscultation and an outcome-oriented alternative approach to the musculoskeletal examination
1981; Wiley; Volume: 15; Issue: 2 Linguagem: Inglês
10.1111/j.1365-2923.1981.tb02406.x
ISSN1365-2923
Autores Tópico(s)Musculoskeletal Disorders and Rehabilitation
ResumoMedical EducationVolume 15, Issue 2 p. 106-109 Inspection-palpation-percussion-auscultation and an outcome-oriented alternative approach to the musculoskeletal examination R. L. Kirby, Corresponding Author R. L. Kirby Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax. Nova Scotia, CanadaDr R. L. Kirby, c/o Nova Scotia Rehabilitation Centre, 1341 Summer Street, Halifax, Nova Scotia, Canada B3H 4K4.Search for more papers by this author R. L. Kirby, Corresponding Author R. L. Kirby Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax. Nova Scotia, CanadaDr R. L. Kirby, c/o Nova Scotia Rehabilitation Centre, 1341 Summer Street, Halifax, Nova Scotia, Canada B3H 4K4.Search for more papers by this author First published: March 1981 https://doi.org/10.1111/j.1365-2923.1981.tb02406.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Summary Thirty-two university-based doctors and sixty-seven medical students used a visual analogue scale (VAS) to estimate the usefulness of the inspection-palpation-percussion-auscultation (IPPA) approach. Doctors considered IPPA less useful in the examination of the musculoskeletal system than in other systems, both in clinical practice (P<0.01) and as an aid in teaching (P<001). Students rated IPPA less useful in the musculoskeletal examination than in other systems as a learning aid (P < 0.001). Based on these findings, an alternative model for physical examination of the musculoskeletal system was devised, using inspection, palpation and other clinical methods only when required to reach a diagnosis. The model focused on the outcome of the diagnostic process (aetiological, anatomical/ pathophysiological and functional diagnoses) rather than on the process itself. Thirteen students taught this method found it a useful learning aid. Those familiar with both methods preferred the outcome-oriented to the IPPA method (P<0.001). References Bomford, R.r., Mason, S. & Swash, M. (1975) Hutchison's Clinical Methods, 16th edition. Baillière and Tindall, London . Google Scholar R.D. D' Ambrosia (Ed.) (1977) Musculoskeletal Disorders: Regional Examination and Differential Diagnosis. J. P. Lippincott Company, Philadelphia . Google Scholar Degowin, E.L. & Degowin, R.L. (1976) Bedside Diagnostic Examination, 3rd edition. MacMillan Publishing Company, Inc., New York . Google Scholar Green, G. & Defoe, E.C., JR. (1978) What is a clinical algorithm Clinical Pediatrics, 17, 457. 10.1177/000992287801700512 PubMedWeb of Science®Google Scholar Hoppenfeld, S. (1976) Physical Examination of the Spine and Extremities. Appleton-Century-Crofts, New York . Google Scholar Keele, K.D. (1966) Uses and abuses of medical history. British Medical Journal, 2, 1251. 10.1136/bmj.2.5524.1251 PubMedWeb of Science®Google Scholar Kirby, R.L. (1979) The third dimension-functional diagnosis (abstract). Annals of the Royal College of Physicians and Surgeons of Canada, 12, 78. Google Scholar J.G. Macleod (Ed.) (1976) Clinical Examination, 4th edition. Churchill-Livingstone, Edinburgh . Google Scholar Mcwhinney, I.R. (1972) Problem-solving and decisionmaking in primary medical practice. Proceedings of the Royal Society of Medicine, 65, 934. PubMedWeb of Science®Google Scholar Pauker, S.G. & Kassirer, J.P. (1980) The threshold approach to clinical decision making. The New England Journal of Medicine, 302, 1109. 10.1056/NEJM198005153022003 PubMedWeb of Science®Google Scholar Tanner, T.H. (1856) A Manual of Clinical Medicine and Physical Diagnosis, 2nd American edition. Blanchard and Lea, Philadelphia . Google Scholar Zentgraf, R. & Victor, N. (1978) Some problems arising in the statistical treatment of diagnosis. Methods of Information in Medicine, 17, 10. PubMedWeb of Science®Google Scholar Citing Literature Volume15, Issue2March 1981Pages 106-109 ReferencesRelatedInformation
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