Area of PM&R that is most diagnostic?

[JBM16BYU]

Hi everyone! As I’m continuing to explore the different areas of PM&R, I’m realizing how much I enjoy diagnosis. That being said, in y’all’s opinion, which areas of PM&R provide the most opportunities for diagnosis as opposed to patients already coming with a diagnosis and being primarily management of an already established diagnosis?

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[j4pac]

MSK is pretty diagnostic...whether it be pain or Sports. Neuro rehab does have a fair share...but the diagnostic part of it comes into play when trying to figure out why people have impairments. Neuro rehab patients can be very complex so it’s not uncommon that you come across some interesting diagnostic dilemmas.

 

[Piebaldi]

MSK is pretty diagnostic...whether it be pain or Sports. Neuro rehab does have a fair share...but the diagnostic part of it comes into play when trying to figure out why people have impairments. Neuro rehab patients can be very complex so it’s not uncommon that you come across some interesting diagnostic dilemmas.

I would add spinal cord injury also - determining ASIA scores, etc.

 

[timisdaman]

To be quite honest, it is true when your medical school teachers tell you that 90% of the time, you can make the diagnosis from history alone.

Sports and/or Pain offer diagnostic ultrasound and diagnostic injections.

Neuromuscular offers EMG/NCS.

All sub-specialties, and just general physiatry as well, allow you to work up patients as appropriate with history, physical, labs, imaging, etc.

 

[RangerBob]

I agree the most diagnostic areas are MSK/sports/EMG.

In inpatient rehab, which is what I do, the diagnosis/workup is already done for 95% of the patients. Someone else did the workup-though they aren’t always right.