Diagnosing orthopedic symptoms can be tricky. X-rays, for example, don’t tell you a lot about tendons and ligaments that are often responsible for joint pain. More advanced testing, like MRI, is costly, and often requires prior authorization from insurance companies leading to a delay in treatment. While there are a number of clinical orthopedic exam maneuvers that indicate the exact type of injury and help lead nurse practitioners to a diagnosis, the specifics of these exam techniques can be difficult to recall on the spot.
Fortunately, there are a few quick references, both electronic and print, on the market to aid nurse practitioners in the diagnosis and treatment of orthopedic conditions, including advanced exam techniques. If you could use a refresher when it comes to your orthopedic exam know how, check out the following references.
1. CORE – Clinical ORthopedic Exam
Have difficulty remembering all of the various orthopedic exams? If you can’t quite recall how to perform the Empty Can Test for supraspinatus impingement, or don’t remember if the Anterior Drawer Test examines the integrity of the ACL or MCL, then this is the app for you. With over 400 clinical exam maneuvers listed by anatomical structure, CORE makes these exams easy to find and reference in your clinical practice. The app even contains videos demonstrating these tests. At $39.99, the app is a bit pricey, so consider purchasing the resource with your continuing education budget.
A more budget friendly option than our prior pick, iOrtho+ is a comprehensive reference for orthopedic tests and joint mobilization techniques. Simply select a joint on the skeleton diagram to drill down to individual tests and techniques. Links to full text references support clinical content contained in the app. The first five uses of iOrtho+ are free, so there’s no risk to giving the app a trial run.
3. Pocket Guide to Musculoskeletal Diagnosis
If you’re more of a pencil and paper kind of nurse practitioner, pocket guides serve as a helpful resources in place of apps. Dr. Grant Cooper’s Pocket Guide to Musculoskeletal Diagnoses details questions to ask in history taking, physical exam maneuvers, additional tests needed to diagnose the condition, and the most up-to-date treatment guidelines for orthopedic conditions. Included photos are helpful for demonstrating exam maneuvers.
4. Ortho Notes: Clinical Examination Pocket Guide
Another physical pocket guide, Ortho Notes: Clinical Examination Pocket Guide, features handy tabs for each joint. Under each tab, nurse practitioners will find subcategories for different orthopedic pathologies and their associated medical screenings, imaging, mechanism of injury, ROM, strength and functional deficits, and special tests. The guide comes with high marks from users, and is more affordable than our prior pick at around $25.
5. Orca Health ‘Decide’ Series
Orca Health has a series of apps, with each app designed for a specific anatomical area. Orthopedic app options include those for the knee, shoulder, hand, hip, foot, and spine. Within each app, users will find anatomical models, examples of normal and abnormal images, and videos of common conditions and procedures. In addition, the ‘Decide’ app series features stretching, strengthening, and dynamic exercises nurse practitioners may wish to recommend to patients.
What are your favorite orthopedic apps and pocket guides?
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