Examining the musculoskeletal system remotely
This article in Pulse magazine gives some sensible and pragmatic advice on how to assess patients presenting with MSK symptoms online. It has some case studies which highlight some of the key points, including the key red flags.
It does point out that on some occasions a face-to-face appointment for a hands-on examination will still be necessary despite our best remote efforts, but gives you the best chance of assessing as comprehensively and safely as possible over video.
There are many useful points, but I’ve picked out the gems I think we could use:
. Don’t forget general observation skills e.g. walking aids, obvious discomfort, asymmetry
. Take more care to rule out any red flags by direct questioning, as you can take less for granted remotely
. Follow a clear structure in your history and examination, don’t be put off by patients trying to rush, or technical problems
. Be aware of possible information gaps and pitfalls of remote consulting and take this into account, especially with safety netting
. Know when to revert to face-to-face