The Importance of Clinical Reasoning in MSK
- 7th November 2017
- Posted by: Jill Kerr
- Category: SOMM Blog,
What makes a good Musculoskeletal Medicine Therapist?
The ability to assess and diagnose an injury is key to facilitate the correct treatment and clinical outcomes for patients. Chartered Physiotherapists and General Practitioners are ideally placed to carry out these assessments….
The Therapist must ensure that the history from the patient has a good fit with the findings of the physical assessment and this then leads to the clinical diagnosis of the patient’s musculoskeletal problem.
The Therapists’ explanation to the patient of the likely diagnosis, and the reasons for this diagnosis whilst explaining the various treatment options available to the patient, really helps with patient compliance and satisfaction.
An experienced clinician should be able to identify when patients need further investigation for suspected more serious pathology, when identifying red flags during the examination.
How does clinical reasoning help?
Clinical reasoning is making sense of the clinical findings with an investigative mind, so therapists can rule out more serious pathology, detect patterns of common MSK lesions and ensure we understand/meet the individual needs/goals that each patient may have.
When discussing patient presentations with colleagues there will be questions regarding the clinical reasoning process you have followed during your assessment and what has guided your decisions. Justifying your diagnosis and why you chose certain examination questions and physical tests can vary but you need to be able to explain why you chose to include or exclude certain questions or tests.
The more experienced MSK practitioner may do this clinical reasoning subconsciously and the less experienced therapist may have to review the results of their examination to look at the potential differential diagnosis for their findings.
What skills or qualifications do I need?
A sound knowledge and understanding of functional anatomy, how pain works/nerve supply of structures, connective tissue behaviour and response to injury is needed and will allow us to assess the degree of injury to each patient.
The SOMM Foundation Modules give MSK therapists the tools needed to enhance their clinical reasoning and diagnostic skills. The SOMM clinical assessment framework is designed to be succinct and inclusive with a filtering process to rule pathologies in and out and to be of benefit to both GPs and Physiotherapists.
To enhance clinical reasoning skills for assessment and be aware of all differential diagnosis to common MSK problems our Foundation Modules will give you the skills to do this.