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Differential Diagnosis for Physical Therapists—Screening for Referral, ed 4

Goodman CC, Snyder TK. St Louis, MO 63146, Saunders, 2007, paperback, 944 pp, illus, ISBN: 13-978-0-7216-0619-4, $69.95.

There are 3 main sections in this text, with an easy-to-follow format. In general, the content materials of each chapter are supported by generous use of boxed items and tables with important points to remember. Case examples reinforce key points. Tips on how to phrase screening questions, pertinent follow-up questions, and recording forms help hone the screening abilities of the practitioner. Case studies and practice questions (with an answer key in the back of the text) provide useful self-assessment tools for the reader. In addition, information on publications from APTA and instructions on how to access them on the Internet are helpful materials that clinicians can readily apply to their practice. Each chapter ends with key points to remember. References are ample, current, and support the materials presented.

The first section, chapters 1 through 4, focuses on the screening interview and includes many photos and illustrations that reinforce different pain types and viscerogenic pain patterns. This material was designed to enable the physical therapist to recognize areas beyond their scope of practice or expertise and to provide a step-by-step approach to identify those patients/clients who need a referral to or consultation with another health care professional. Chapter 1 focuses on the screening process, whereas chapter 2 covers the interviewing process. The third chapter explains the mechanisms of referred pain, and the final chapter combines the use of the screening and interviewing processes, the mechanisms of referred pain, and physical assessment as a screening tool, all of which assist the practitioner in developing and refining the clinical-reasoning process.

Section II, chapters 5 through 13, discusses specific screenings for diseases related to each body system, such as the cardiovascular and urogenital systems. Each chapter follows a similar pattern, including red-flag history, risk factors, and clinical presentation and signs and symptoms. Pathophysiology, conditions specific to the body system, guidelines for physician referral, key clues to screening, and pain patterns associated with a given body system are included.

The final section focuses on specific body parts from head to toe. Chapters 14 through 18 cover the head, neck and back; the sacrum, sacroiliac and pelvis; the buttock, hip, thigh, groin, and leg; the chest, breast, and ribs; and the shoulder and upper extremity. Location and sources of pain and symptoms are related to screening for causes from other body systems, such as the gastrointestinal and liver and biliary systems. Similar to section II, each chapter ends with guidelines for physician referral and clues for screening. Referred pain patterns also are included, which summarize key points in each chapter.

There are several appendixes that summarize key elements from the entire text. For example, there are tables of quick screen checklists, red flags, and systemic causes of joint pain in Appendix A. The other appendixes include tables of special questions to ask, special forms to use, and special tests to perform to a specific body system. The CD-ROM (Macintosh or Windows 98SE, 2000, or XP) that accompanies this text includes all the information found in the appendixes. These can be downloaded for use in the clinic. The same information can be accessed through the EVOLVE Web site, access to which is included with the text.

This textbook covers the multiple facets upon which physical therapists' clinical reasoning is based. It does meet its intended goal "to provide the therapist with a consistent way to screen for systemic disease and medical conditions that can mimic neuromusculoskeletal problems." The abundance of tables, forms, and quick checklists make this text easy to use, and it should be a mainstay in professional libraries. Not only is this an important textbook for physical therapists and physical therapist assistants and students, but it is an essential teaching tool for faculty in physical therapy programs.

Elaine L Bukowski

EL Bukowski, PT, DPT, is Professor of Physical Therapy and Associate Director, Post-Professional DPT Program, Richard Stockton College of New Jersey, Pomona, NJ

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This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bukowski, E. L Search for Related Content PubMed Articles by Bukowski, E. L Related Collections Diagnosis/Prognosis: Other Social Bookmarking                      What's this?