The Science & Art of Musculoskeletal Diagnosis: Volume II: Applying Principles to Cases

Volume II: Implementation with Case Studies Based on more than 50 years of evolving clinical practice, 'The Science & Art of Musculoskeletal Diagnosis, Volume II, presents 27 selected cases drawn mostly from Mark Laslett’s clinical practice and research. Other clinicians have provided some cases as well, to ensure the principles are seen to apply across the musculoskeletal system, not just the lumbar spine. This Volume should be seen as a companion text to Volume I, where the principles underlying the Science and Art of Diagnosis are described in detail. Indeed, the original intent was to present principles and case reports in a single volume, but the size of the book would have been excessive, hence the division into two Volumes. This Volume applies the Principles to actual real-life cases, using detailed patient records to illustrate the application of these principles in order to reach the most probable clinical diagnoses. Follow-up assessments detail how criterion standard diagnostic testing compares with the clinical diagnosis achieved at initial assessment. Volume I has two Sections detailing the Science and Art of diagnostics. This Volume continues with Sections 3 and 4. Section 3. Provides details of the initial clinical assessment for all 27 cases, including: Clinical history Pain drawings Measures of pain intensity, disability and psychosocial distress Observations of each patient, including general appearance and active movements Physical examination procedures, including Neurologic screening examination Sacroiliac joint provocation testing Repeated movement testing for centralisation and directional preference phenomena Other special tests, such as imaging, available at the time of first assessment Section 4. Provides details of follow-up assessments. Some patients have been followed up for several years. Where applicable, imaging, results of interventional diagnostic procedures and clinical follow-up are reported. The reader is encouraged to use the principles described in Volume I by documenting diagnostic conclusions in the Table provided at the end of each case in Section 3. Once a clinical diagnosis is achieved in Section 3, the reader can look at the follow-up and conclusions for the same case in Section 4, to review the reasoning process and accuracy of the clinical diagnosis. This Volume is no substitute for active in-clinic mentoring. Still, it provides a unique opportunity for novice and experienced clinicians to attempt and explore clinical diagnoses based on the same data available to practising clinicians (Section 3), and test that against actual follow-up data in Section 4.