Forward head posture can be a result of thoracic hyperkyphosis, but it can also be a posture that is caused by foot pronation …
Cleveland University reports that becoming better at differential diagnosis leads to better treatment plans. This increases patient satisfaction levels, which also increases the number of referrals to your practice while also strengthening the patient-provider relationship. Some differential diagnosis research and cases differ, such as the case in point below dealing with thoracic hyperkyphosis.
The importance of differential diagnosis: thoracic hyperkyphosis
In differential diagnosis, a patient’s total symptomology is assessed to create a more comprehensive list of the potential conditions that may be causing those effects. This process can be difficult due to many health conditions having numerous possible causes.
For example, research published in the Journal of Craniomandibular & Sleep Practice shares that forward head posture (FHP) can be a result of thoracic hyperkyphosis. But it can also be a posture that is caused by foot pronation, or the person may be tilting their head forward in an attempt to improve airway function that has been compromised by stomatognathic system dysfunction. Some also contend that FHP is a result of increased tension in the anterior or posterior fascial lines.
Making the correct diagnosis is critical to creating an effective treatment plan. If the patient’s forward head posture is caused by stomatognathic system dysfunction, for instance, the treatment protocol will look much different than if its cause lies in thoracic hyperkyphosis. Once the cause is identified, it may also require referring the patient to another healthcare provider who is better equipped to resolve the specific reasons behind that particular presentation.
Most common differential diagnosis practices
In a survey of 503 chiropractors, 95.1% indicated that they perform differential diagnosis procedures. Additionally, the five most common procedures performed were:
- orthopedic testing (88.8%)
- palpation (88.0%)
- history taking (83.5%)
- range of motion testing (80.0%)
- neurological examination (79.9%)
Certain diagnostic practices can also help practitioners better decide the best site for applying manipulation treatments. One review found that the methods most effective for this purpose include static or motion palpation and leg length inequality measurements, with some evidence to support the value of postural evaluations.
Improving your differential diagnosis skills
Improving your differential diagnosis abilities can be achieved with continuing education (CE) courses. These courses are available from multiple sources, and many are available online making them easier to fit into your busy schedule.
Palmer College of Chiropractic offers several online CE courses and programs, many of which fall under the umbrella of the most common differential diagnosis procedures. In the Chiropractic Documentation course, for instance, you can learn more about history taking as it includes a discussion on obtaining a history of the patient’s present illness in addition to establishing their past medical, family, and social history.
If you want to learn more about orthopedic testing, Palmer offers a CE course titled “MRI Extremity Basics.” This one-hour class discusses how to identify pathologies affecting the bone, muscle, and connective tissues, also providing tips for communicating these pathologies to patients.
Northwestern Health Sciences University provides online CE courses directed toward these topics as well. Concussions are neurologically based, so diagnosing them involves conducting a neurological assessment. Northwestern’s course “CCC – Chiropractic Care for Concussions and Post-Concussion Syndrome” discusses how to diagnose this condition via history-taking and examination procedures.
Another of Northwestern’s courses teaches chiropractic professionals how to use palpation to assess the flow of cerebro-spinal fluid. This influences the diagnosis of cranio-sacral issues, also impacting the desired therapeutic protocol.
Which CE courses should you take?
There is no one-size-fits-all answer to this question. Instead, selecting the CE courses that make the most sense for you depend on a variety of factors. They include deciding the types of differential diagnosis procedures you are interested in learning more about or even identifying the areas where your current skills may fall a bit short and could be improved.
It’s also helpful to consider your patient demographic. Do they tend to have more neurological or orthopedic issues, for example? The types of conditions that they deal with more frequently may dictate where you need more knowledge to make a proper diagnosis.
Taking factors such as these into consideration can help you decide the best differential diagnosis CE courses for you.
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