The answer is in the questioning: Subjective history taking and serious spinal pathology

Article type: Research Article

Authors: Wardle, F. | Greenhalgh, S. | Selfe, J.

Affiliations: Advanced Orthopaedic Practitioner, Elective Orthopaedics, Orthopaedic Department – Bolton Foundation Trust, Bolton, UK | Consultant Physiotherapist, Elective Orthopaedics – Bolton Foundation Trust, Bolton, UK | Professor of Physiotherapy, School of Sport, Tourism and The Outdoors University of Central Lancashire Preston, UK

Note: [] Corresponding author: Fiona Wardle, MSc, BSc (Hons), MCSP, SRP, Bolton NHS Foundation Trust, Bolton, UK. E-mail: [email protected]

Abstract: This case presents a 43 yr old woman with an eight-week history of progressing leg weakness set against a long history of chronic back pain. She was referred to the Orthopaedic department following referral from her General Practitioner. The weakness became so distressing to the patient that it resulted in a prior attendance at an Accident & Emergency department. The case illustrates the complexities of clinical reasoning within the area of serious pathology of the spine. It demonstrates the importance of detailed subjective history questioning in the quest for early diagnosis, which is particularly important for clinicians who work in an autonomous or extended role.

Keywords: Spine, red flags, clinical reasoning, case study

DOI: 10.3233/PPR-140041

Journal: Physiotherapy Practice and Research, vol. 35, no. 2, pp. 87-93, 2014