The second course
in this instructional program gets into the nitty-gritty of diagnostic
methodology within the clinic on the real patients we see every day. The focus
here is on clinical diagnosis. That is, the diagnosis one can achieve in the
clinic using the history and physical examination, and highly selective use of
three formal lessons to complete. The lessons are:
- Sources and causes of Low Back and
Referred Lower Limb pain. This is a basic overview of known painful
patho-anatomical categories of conditions. Basic knowledge is assumed of course
but the idea is to provide a summary of basic categories for context and
content needed for the next two lessons
- The second lesson is Part 1 of the
lesson on Diagnosis by Subtraction. Diagnosis by subtraction draws on the
concepts of specificity & sensitivity to rule in and rule out different
- The third lesson is Part 2 of the
lesson on Diagnosis by subtraction. In this lesson you will see how expert
clinicians reduce the pool of possible diagnostic conclusions to one, or a
small number of diagnostic possibilities, so that treatment can be initiated or
further diagnostic investigation planned.
one case study video to watch. This shows the centralization of pain
graphically which is important, since centralisers are the largest subgroup
within the back pain population.
also download the case notes of the patient seen in the introductory course and
be encouraged to self test your own clinical reasoning skills using the details
of this case and the learning from the three lectures on the principles of
only one paper to download and read, and that is the 2017 paper of Petersen,
Laslett & Juhl on the systematic reviews we carried out on the latest
evidence on diagnosis and classification. You will need to read this
thoroughly, because the course quiz will focus on that strongly.
At the end
there is a quiz to test your understanding of the material.
will be able to download the PDF forms I have used for clinical records. This
documentation may be of use, or may not, but does give you a good idea of the
sort of questionnaires I have patients complete, and notes I keep for all cases
presenting in the clinic.