Locomotor Portfolio Case Report

Mr Gavin BrownLocomotor Clinical Teaching Fellow

8th October 2015

Issues Particular to Locomotor

– Different signs/symptoms from initial – Difficult to examine–May already have had definitive

treatment– Orthopaedic involvement may have

finished– Comorbidities acutely worsened, now

major issue

Issues Particular to Locomotor

– Present findings prior to surgery/intervention

– Include ICE pre and post intervention– Differential diagnosis at this time– Extensive management plan• Justify each aspect• Sensible progression of

investigations/interventions• Report any completed

Layout

• PC• HPC

– Specific features of locomotor history taking relevant to joint/region and function

• Past medical/surgical Hx• Drug history & allergies• Social history• Systematic enquiry of symptoms not previously covered• Examination findings (with relevant negative findings)

Layout

• Diagnostic summary• Management plan– Explanation/justification in discussion

• Patient’s ideas, concerns and expectations• Discussion

Discussion

• Approx 4 pages• Basic science • Explanation/justification of plan• Pertinent programme themes–2-3 for adequate discussion

Common Topics

• Ortho PAC prior to scheduled surgery• I/P on ortho ward after elective surgery for a chronic

condition• I/P on ortho ward after emergency surgery for an

acute condition• I/P on rheum or ortho ward with an acute, or acute

on chronic, problem• O/P in rheum or ortho clinic at any point in progress