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Digital Seminar

Orthopedic Diagnostic Tests

Linking Physical Assessment with Imaging Interpretation

Speaker:
Paul Langlois, APN, PhD, CCRN, CCNS
Duration:
2 Hours 02 Minutes
Format:
Audio and Video
Copyright:
May 22, 2024
Product Code:
POS078843


Description

A variety of tests can be used to diagnose and screen for orthopedic conditions. Some diagnostic tests help determine the location and severity of the condition, while others may help rule out other possible causes of the symptoms.  

There are continuous updates on when to order and not order specific tests.  In 2024, the American College of Radiology (ACR) updated their “Appropriateness Criteria” for several diagnostic tests and procedures.  In this presentation, the changes to the guidelines as well as the established practices will be presented on assessment and imaging of the following musculoskeletal parts: cervical, thoracic and lumbar-spine; elbow, hand, wrist, hip, ankle and soft tissue conditions. Topics will include when to order the following tests: x-ray, CT scan, MRI, ultrasound, bone density, myelogram, bone scan and fluoroscopy 

With a definitive diagnosis, the clinician can develop an individualized treatment plan to address the specific orthopedic condition and get the patient to their optimal level of functioning.  

Credit

Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.



* Credit Note - **

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after passing the online post-test (80% passing score) and completing the evaluation). Instructional methods will include PowerPoint, didactic lecture, and others.

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Program content is reviewed periodically per accrediting board rules for currency and appropriateness for credit. Credit approvals are subject to change. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education, as well as which credit types are acceptable for continuing education hours. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. 
For other credit inquiries not specified below, please contact info@pesi.com or 800-844-8260 before purchase.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of your profession.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your profession's standards.  

For Planning Committee disclosures, please see the statement above.  For speaker disclosures, please see the faculty biography.


* Credit Note - ---

Earn up to 2.0 CE hours. Please see below, for more details, as credit amounts vary by state and profession. 


Nurses - Nurses, Nurse Practitioners, and Clinical Nurse Specialists - ANCC

PESI, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Nurses completing these self-study materials will earn 2.0 contact hours. Expires: 05/17/2027.


Nurses - California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 17118 for 2.0 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Nurses - Florida Nurses

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 2.0 self-study contact hours.

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Nurses - Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 2.0 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


Physical Therapists - Alaska Physical Therapists & Physical Therapist Assistants

CE credit is available. This self-study course consists of 2.0 continuing education credit hours for Alaska Physical Therapists. The Board Rule 12 AAC 54.420 confirms acceptance of continuing education programs that are recognized by other state physical therapy licensing boards. PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers.


Physical Therapists - Arizona Physical Therapists & Physical Therapist Assistants

CE credit is available. The Arizona State Board of Physical Therapy recognizes continuing competence activities that have been approved by any state PT association or national medical/health care association (e.g., AOTA, ASHA). This self-study activity consists of 2.0 clock hours of instruction applicable for physical therapists.


Physical Therapists - California Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the Physical Therapy Board of California as an approval agency to approve providers. This self-study lecture qualifies for 2.0 continuing competency hours.


Physical Therapists - Physical Therapists & Physical Therapist Assistants

This self-study course consists of 2.0 clock hours of instruction that is applicable for physical therapists. CE requirements for physical therapists vary by state/jurisdiction. Please retain the certificate of completion that you receive and use as proof of completion when required.


Physical Therapists - Illinois Physical Therapists & Physical Therapist Assistants

PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270. This self-study course qualifies for 2.0 CE credit hours.


Physical Therapists - Kentucky Physical Therapists, Physical Therapist Assistants

This self-study course consists of 2.0 continuing education credit hours. For Kentucky licensees, according to 201 KAR 22:045, this self-study educational offering may be applied toward Category 2 continued competency requirements.  Please review the regulation to determine eligibility. 


Physical Therapists - New York Physical Therapists & Physical Therapist Assistants

PESI, Inc. is recognized by the New York State Education Department, State Board for Physical Therapy as an approved provider for physical therapy and physical therapy assistant continuing education. This self-study course qualifies for 2.4 contact hours.


Physical Therapists - North Carolina Physical Therapists & Physical Therapist Assistants

PESI, Inc. is an approved provider with the Illinois Division of Professional Regulation, Provider Number: 216.000270. This intermediate course is approved by the North Carolina Board of Physical Therapy Examiners by virtue of PESI Inc. approved provider status with the Illinois Division of Professional Regulation. This course qualifies for 2.0 continuing education hours.


Physical Therapists - Oklahoma Physical Therapists, Physical Therapist Assistants

CE credit is available. This asynchronous activity consists of 2.0 continuing education credit hours for Oklahoma Physical Therapists. Oklahoma Administrative Code 435:20-9-3.1 confirms acceptance of continuing education programs offered by providers approved by other state physical therapy licensing boards. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.


Physical Therapists - Pennsylvania Physical Therapists and Assistants

The Pennsylvania State Board of Physical Therapy recognizes approval by all other state boards. This self-study activity consists of 2.0 clock hours of instruction that is applicable for physical therapists.


Physical Therapists - Texas Physical Therapists & Physical Therapist Assistants

This self-study activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2406032TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas. Instructional Level: Advanced. This activity will provide 2.0 CCUs. The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE. Full attendance is required; no partial credits will be offered for partial attendance.


Physical Therapists - Utah Physical Therapists And Physical Therapist Assistants

This course is designed to meet the Utah DOPL Rule R156-24b-303b.2.c.iv - A commercial continuing education provider providing a course related to the practice of physical therapy. Please retain a copy of the advertising brochure and your certificate of completion to provide to your board should this be requested of you. This self-study activity consists of 2.0 clock hours of continuing education instruction.


Physical Therapists - Vermont Physical Therapists & Physical Therapist Assistants

CE credit is available. This course consists of 2.0 continuing education credit hours for Vermont Physical Therapists. The Board confirms acceptance of continuing education programs that are recognized by other state physical therapy licensing boards. PESI, Inc. is a Registered Physical Therapy Continuing Education Sponsor through the State of Illinois Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 216.000270.


Physical Therapists - Virginia Physical Therapists & Physical Therapy Assistants

CE credit is available. This self-study course consists of 2.0 hours of type 2 continued competency credit for Virginia Physical Therapists and Physical Therapy Assistants. Regulation 18VAC112-20-131, Section B, (2) states that up to ten type 2 continued competency credits can be earned by completing independent study activities related to the clinical practice of physical therapy. 


Physicians - Physicians

PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PESI, Inc. designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. This activity was originally recorded on 05/22/2024. It was last reviewed on 07/27/2024 and is valid until 07/26/2027.

 

Physicians should only claim credit commensurate with the extent of their participation in the activity. You are required to successfully complete and submit a post-test prior to receiving a certificate of completion.


Athletic Trainers - Athletic Trainers

PESI, Inc. is recognized by the Board of Certification, Inc. to offer continuing education for Certified Athletic Trainers. This self-study program has been approved for a maximum of 2.0 hours of Category A continuing education.


Other Professions

This self-study activity qualifies for 2.0 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.



Handouts/Brochure

Speaker

Paul Langlois, APN, PhD, CCRN, CCNS's Profile

Paul Langlois, APN, PhD, CCRN, CCNS Related seminars and products


Paul Langlois, APN, PhD, CCRN, CCNS, is a critical care clinical specialist in the surgical, medical, neurologic, burn, CCU, and trauma ICUs of Cook County Hospital, Chicago. Drawing on over 40 years of experience assessing and managing patients with life-threatening diseases, Dr. Langlois provides advanced-level training to nurses, physician assistants, nurse practitioners, respiratory therapists, and physicians.

Dr. Langlois is committed to providing the highest quality of care to patients through advanced education. His presentations are evidence-based, timely, and provide participants with numerous case studies to facilitate critical thinking. As a bedside clinical nurse specialist, he has developed several institution-wide protocols for the multidisciplinary assessment and management of infectious disease and multi-system organ failure patients.

His presentations are enthusiastically delivered and offer highly practical tips that help make the most challenging concepts easy to understand. Linking knowledge to clinical practice is the goal of every educational program.  

 

Speaker Disclosures:
Financial: Paul Langlois has employment relationships with Cook County Hospital and Emergency Care Consultants. He receives a speaking honorarium and recording royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Paul Langlois is a member of the American Nurses Association and the American Association of Critical Care Nurses.


Additional Info

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Questions?

Visit our FAQ page at www.pesi.com/faq or contact us at www.pesi.com/info


Objectives

  1. Determine five key factors when performing an orthopedic physical assessment. 
  2. Analyze the appropriateness of non-invasive tests to be performed based on the patient’s presentation for the following: Cervical spine pain, thoracolumbar pain, painful joints (shoulder, elbow, wrist, knee, hip and ankle). 
  3. Evaluate presentations that would require a clinician to order radiographic tests (x-ray, CT, MRI, fluoroscopy, bone scan, myelography) versus non-radiographic tests (ultrasound, electrodiagnostic/EMG)) for bone and joint pain. 

Outline

Conducting an Orthopedic History and Physical Assessment 

  • Medication classes that affect orthopedic history and assessment 
  • Clinicians can do better than the acronym AMPLE (allergies, medications, past medical history, last eaten, events leading to symptoms) in history taking  
  • The two most missed assessments on your orthopedic patient 
  • Pain: Differentiate between point tenderness versus nerve transmission  
  • Distinguishing features of bone, nerve, joint and soft tissue damage or inflammation 
  • Is RICE (rest, ice, compression and elevation) enough or are further tests warranted? 

Physiotherapy Tests and Maneuvers Which Can be Performed in the Outpatient Setting 

  • Cervical radiculopathy versus a neck muscle strain 
  • Shoulder instability and dislocation – perform this non-invasive procedure 
  • Diagnosing lateral epicondylitis in your patient without x-rays 
  • Is this carpal tunnel, arthritis or tendonitis?   
  • How to diagnose the most common injury of the knee without radiation 
  • Lumbar radiculopathy: Is it disc herniation or something else  
  • Strategies to differentiate Achilles tendon rupture or Aspergilloma – they may present similarly  

Cervical Spine Maladies 

  • Does this patient warrant a radiograph, CT or MRI? 
  • When should contrast be used for the CT and MRI? 
  • Four must-consider factors before imaging the cervical spine 
  • Situations that require a radiographic odontoid view on your patient 

Thoracic and Lumbar Spine Injuries 

  • Always get an MRI when the patient’s history and assessment reveal this finding 
  • When is the axial or sagittal view best for diagnosis 
  • Determine when a myelogram should be ordered on your patient 

Stress Fractures 

  • Bedside ultrasound is all that may be warranted for a diagnosis 
  • When is bone scan, CT or MRI needed? 
  • Frequent fractures: Bone mineral density scan can provide the diagnosis with T- and Z- scores 

Painful Joints 

  • Fluoroscopy is better than CT or MRI when the patient presents with these findings 
  • Physical exam suggests carpal tunnel syndrome; when to get electrodiagnostic testing (electromyography, EMG) 

Case studies 

Reviews

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