Hi and thanks for this neat way of presenting learning material, Jack. I like it!
However, like Séamus McNally below, I too was missing the bit on differential diagnosis - I see you covered this before so I'm late to the table. Thanks for adding it.
I only say it because long ago when I first qualified, I had a patient with bilateral ankle pain, and also some intermittent dizziness. She was recently retired but had previously been an air hostess as they were then called, in times when they had to wear high hells too. She had also survived an air crash where she'd been standing serving when the plane crash-landed!
Not knowing much at about peripheral spondyloarthritis at the time, but doing a header into commission bias, I assumed these ankles must have sustained damage from the compression forces of the accident, and referred her to her doctor for this otherwise unusual presentation, and to get the dizziness checked. By the time she finally went to her GP months later, the tumour in her bowel had become so enormous as to have become inoperable. Both her bilateral ankle pain and her dizziness were put down to effects of her cancer by her specialists. Ever sine then I have followed up on such referrals promptly to make sure they have actually done what was advised.
I am no way wagging my finger here as you are such an expert, but maybe if you do continue these lovely nuggets, the DDx would be very welcome.
Many thanks again. I'll subscribe properly once my talk on Physio Matters is over! Great resource.
There are 3 reasons differential diagnosis isn't included in this particular piece
1. It's in the previous piece
2. It would cloud the point I was trying to achieve with this specific doc
3. It isn't my skill set to teach all aspects of medical masqueraders, there are people much better than I with in your example oncology! I try to stick the MSK and Rheum. Even though I acknowledge that is a little limiting
You will be brilliant on the Spinal Masterclass by the way 👍👍👍
I did see 1. in your previous reply and of course you’re addressing a qualified audience too. Totally respect what you’re saying & thanks for the thumbs up!
Yeah, Jack, that’s exactly what I thought. I wasn’t being’smart’ I’m a podiatrist and would genuinely like to get your take on differential assessment. Another article?🤓
Sure of course 👍
My previous article included differential diagnosis vs tendinopathy https://open.substack.com/pub/rheumatologyphysio/p/enthesitis
That part is behind the paywall though
Hi and thanks for this neat way of presenting learning material, Jack. I like it!
However, like Séamus McNally below, I too was missing the bit on differential diagnosis - I see you covered this before so I'm late to the table. Thanks for adding it.
I only say it because long ago when I first qualified, I had a patient with bilateral ankle pain, and also some intermittent dizziness. She was recently retired but had previously been an air hostess as they were then called, in times when they had to wear high hells too. She had also survived an air crash where she'd been standing serving when the plane crash-landed!
Not knowing much at about peripheral spondyloarthritis at the time, but doing a header into commission bias, I assumed these ankles must have sustained damage from the compression forces of the accident, and referred her to her doctor for this otherwise unusual presentation, and to get the dizziness checked. By the time she finally went to her GP months later, the tumour in her bowel had become so enormous as to have become inoperable. Both her bilateral ankle pain and her dizziness were put down to effects of her cancer by her specialists. Ever sine then I have followed up on such referrals promptly to make sure they have actually done what was advised.
I am no way wagging my finger here as you are such an expert, but maybe if you do continue these lovely nuggets, the DDx would be very welcome.
Many thanks again. I'll subscribe properly once my talk on Physio Matters is over! Great resource.
Helena
Hey Helena, thanks for commenting.
There are 3 reasons differential diagnosis isn't included in this particular piece
1. It's in the previous piece
2. It would cloud the point I was trying to achieve with this specific doc
3. It isn't my skill set to teach all aspects of medical masqueraders, there are people much better than I with in your example oncology! I try to stick the MSK and Rheum. Even though I acknowledge that is a little limiting
You will be brilliant on the Spinal Masterclass by the way 👍👍👍
Thanks for explaining points 1.-3.
I did see 1. in your previous reply and of course you’re addressing a qualified audience too. Totally respect what you’re saying & thanks for the thumbs up!
No discussion on differential diagnosis?
I was trying to keep the case study activity specific which meant leaving some stuff out.
Yeah, Jack, that’s exactly what I thought. I wasn’t being’smart’ I’m a podiatrist and would genuinely like to get your take on differential assessment. Another article?🤓