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|Book Review: Orthopedic Physical Assessment, 6th Edition|
Title: Orthopedic Physical Assessment, 6th Edition
Authors: David J Magee, PhD, BPT, C.M.
Assessment is the foundation of clinical practice, and a thorough assessment is required to understand the pathology underlying a patient’s presentation in order to set treatment objectives and begin formulation of a treatment plan with the patient. Orthopedic Physical Assessment uses the SOAP note framework to outline recommended assessment techniques for the major musculoskeletal regions of the body. The beginning of the text focuses on taking a detailed patient history using a patient-centered care model. Magee also provides explanations of the various assessment techniques available to clinicians based on the presenting pathophysiology, along with their respective clinical grading scales/classifications or outcome measures. The remaining chapters each cover a critical section of the axial musculoskeletal divisions of the spine and pelvis as well as the major appendicular joints of the upper and lower limbs. These chapters begin with an applied anatomy review, followed by pertinent patient history questions to ask and explanations of the clinical implications of positive reports during the history. Magee synthesizes this information into assessment schemas for particular clinical diagnoses to aid with interpretations of findings so that the reader can begin to develop pattern recognition to guide his or her assessments as their clinical experience with these diagnoses and assessment skills improve. Specifically, Magee includes useful reference tables that relate clinical signs to their pathological anatomy and/or biomechanics to highlight various treatment goals. The included visual aids clearly demonstrate proper patient positioning as well as clinician hand placement and body mechanics when performing orthopedic special tests. These can be referenced quickly without the need to read through the text for a reminder about how to perform the tests.
Anatomical views of the special tests further highlight how to properly interpret the findings based on normal and abnormal results. Magee includes a rating scale for the assessment tests described in each chapter, which incorporates evidence-based practice by rating the tests based on their statistical evidence of validity and clinical support of their use in clinical practice. Functional assessment tools for determining the degree of impairment and other available instruments are recommended and included as full-text forms in the chapter that can be copied and printed for use in clinic. Lastly, the text also includes supplemental chapters on special assessment applications in the areas of gait assessment, emergency sports-related assessment, and assessment of the amputee patient. Moreover, Magee also highlights the importance of cross-disciplinary understanding of assessment practices by including an overview chapter of primary care assessment, to improve the reader’s ability to communicate findings effectively and justify treatment recommendations to other health care professionals within the interdisciplinary care team common to out-patient management.
Prosthetics and Orthotics practice is rarely an exact art where a prescription with a specific diagnosis directly indicates one treatment solution. The inherent ambiguity of diverse patient presentations and unique treatment goals require that CPOs rely on their assessments to inform their clinical decision-making. Magee’s Orthopedic Physical Assessment provides an exhaustive summary of clinical assessment techniques that incorporate the development of clinical reasoning skills as well as psychomotor proficiency with patient examination. While the text is quite detailed and not likely to be read from cover to cover, it is strongly recommended for students looking to supplement their assessment coursework by reading more in depth in relevant chapters and following the suggested guidelines more closely as they acquire more confidence in and mastery of their clinical assessment tasks. Residents would similarly benefit from this text as a reference resource in clinical practice by having ready access to its included full-form assessment tools, applied anatomy and diagnostic imaging reviews, and the well-organized assessment summary tables and visual aids.