Your finger looks really awkward

Aside Posted on Updated on

It’s been 4 weeks into school. We’re adjusting well, I’m adjusting well. It’s weird to start saying we are going for “CP” or “Neuro” or “MS”, sounding more and more like a proper physio than saying we’re going for “Anat” or “Physio” or “Kine”. That’s not to say they aren’t important. I am still quite astounded at how important our foundation is for whatever specific discipline we are studying now.

That’s not to say the transition from year 1 to year 2 was easy. It isn’t, not when you expect yourself to know more things, and having less lecture times as compared to last year. Honestly there will be times when you doubt your own ability as a physiotherapist. It won’t the first and last time throughout my 3 years of studying, I am very sure about this.

Anyway, the main bulk of what was covered for our practicals thus far are the S and O to our AP(IER).

S: Subjective

What, how, when, intensity, pain scale. Yada, yada. This is basically the interview that you carry out with your patient when you see them for the very first time in the clinic and the wards. It consists of loads of systematic questions, and by the end of the interview, you’re supposed to hypothesise the diagnosis. Sounds scary? Yeah, I never did know how asking my patient “So does the pain happen more often in the morning or evening?” actually help me eliminate like half of my differential diagnosis. But not worry, because hospitals will give you this form called the Initial Assessment form, so you kind of won’t forget your subjective assessment. Follow that and you should be pretty much okay, at least so far from what I have observed in the clinic.

O: Objective

Heads up year ones, do get your handling skills down pat. ROM, MMT, muscle length, palpation. You might think that it’s quite lame because you’re practicing them on your able bodied classmates, but when you see patients in the clinical setting where some of them really have limited ROM or super tight muscles after a recon or something, you’ll really appreciate the handling skills that they really drill you with in year one. Plus, they always say: if you don’t know what is normal, then how would you know if something is abnormal?

Let me show you something abnormal then! I always took for granted the little things, but our body is pretty amazing (and frustrating) sometimes.

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This is my left finger. Now you know this looks weird, but deformities could always be genetic in some sense. So how?

#Tip 3746783: Always compare it to the unaffected side. Right?

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Okay, so now for sure you know something is wonky about the left finger. That is my right, uninjured finger for you comparison. It’s straight. The following and some points that you could probably get from my subjective assessment:

  • it was a traumatic incident
  • it happened about a month ago
  • vertical impact
  • pain scale then was about 6/10 with contusions. Right now it’s maybe 2/10 when put in a fully flexed position
  • it’s still swollen

and objective:

  • pain on DIP flexion on OP
  • tightness on DIP flexion
  • no full DIP extension
  • chronic swelling

and differential diagnosis:

  • tearing of my collateral ligaments
  • avulsion fracture
  • compression fracture of my middle phalanx
  • swan-neck deformity
  • mallet finger

So that’s me and my weird finger. And.. my whole rambling on subjective and objective assessments. I have no idea where all that even came from.

BUT YES, I WAS LISTENING DURING MY PRACS OKAY 😀

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