Differential Diagnosis in PT, Part 10: Screening for Systemic Disease - The Shoulder (P)


Screening problems in the shoulder for systemic disease is the focus of this course, which is the final segment (Part 10) of the series: Differential Diagnosis in Physical Therapy. 

This course is designed for physical therapists at all levels from beginner to advanced and working with clients in all settings. This section will review clues suggesting systemic or viscerogenic shoulder pain and take you through each system that can refer pain or symptoms to the shoulder. This will include the GI, pulmonary, renal, gynecologic, and vascular causes of shoulder pain. 

A cognitive processing-reasoning orientation will be utilized throughout the course to encourage students to gather and analyze data, pose and solve problems, infer, hypothesize and make clinical judgments as mechanisms for making appropriate differential diagnoses and referrals. Case studies will be used to integrate screening information in determining a physical therapy diagnosis and making decisions regarding intervention versus referral. 

The instructional focus of this course is on developing advanced clinical reasoning skills related to determining a client’s appropriateness for physical therapy. The course builds on concepts of evidence-based clinical practice as they are used to identify systemic or viscerogenic conditions affecting the shoulder that might mimic neuromuscular or musculoskeletal dysfunction. 

Upon completion of this course, the Learner will be able to:
  • List possible causes of viscerogenic or systemic-induced shoulder pain and dysfunction 
  • List signs and symptoms of systemic origin affecting the shoulder.
  • Describe pain patterns referred to the shoulder originating from each visceral organ system, including: 
    • Cancer 
    • Vascular
    • Pulmonary
    • Gastrointestinal (GI)
    • Renal
    • Gynecologic
  • Recall special questions to ask men and women with significant risk factors, significant past medical history, suspicious clinical presentation and/or associated signs and symptoms that correlate with systemic disease presenting as shoulder pain or dysfunction
  • Describe which shoulder conditions require medical referral

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