Physical Therapy Differential Diagnosis Module 3: Screening for Lower Quadrant, Chest, Breast, Ribs, and Extremities


Course Description

Course Description:

The causes of lower quadrant pain or dysfunction vary widely; presentation of symptoms is equally wide ranging. Vascular conditions (e.g., arterial insufficiency, abdominal aneurysm), infectious or inflammatory conditions, gastrointestinal (GI) disease, and gynecologic and male reproductive systems may cause symptoms in the lower quadrant and lower extremity,1 including the pelvis, buttock, hip, groin, thigh, and knee. Some overlap may occur, but unique differences exist.  

When screening is called for, the therapist looks at the client’s personal and family history, clinical presentation, and associated signs and symptoms. Knowledge of problems that can affect the lower quadrant, along with the likely history, pain patterns, and associated signs and symptoms, should guide the therapist with regard to the steps they should follow during screening. 

The therapist must especially know how and what to look for to screen for cancer, cancer recurrence, and/or the delayed effects of cancer treatment. Cancer can present as primary chest pain with or without accompanying neck, shoulder, and/or upper back pain/symptoms. Basic principles of cancer screening are presented in Chapter 13; specific clues related to the chest, breast, and ribs will be discussed in this chapter. Breast cancer is always a consideration with upper quadrant pain or dysfunction. 

In this chapter, we explore systemic and viscerogenic causes of shoulder and arm pain and take a look at each system that can refer pain or symptoms to the shoulder. This will include vascular, pulmonary, renal, gastrointestinal (GI), and gynecologic causes of shoulder and upper extremity pain and dysfunction. Primary or metastatic cancer as an underlying cause of shoulder pain also is included. The therapist must know how and what to look for to screen for cancer. 

Contact Hours: 10
Text Course Format: Text
Target Audience:
Instructional Level: Intermediate BOC Level of Difficulty: Advanced