With our first true musculoskeletal practical just two days away, we're finally getting into basics of differential diagnosis. As our focus is currently at the hip joint with some potential low-back influences, I originally thought there wouldn't be much to differentiate between. However, as the weeks have gone on and we've learned more and more about symptom presentation, I couldn't have been more wrong. So many things present so similarly!
I imagine this is a skill that develops with time, and that we'll easily be able to rule out certain pathologies simply based on the patient's history. But for now, I find myself fumbling with diagnoses that I should be able to recognize, second-guessing myself and then forgetting the most basic characteristics. I just get lost in the middle of everything, and I find it very difficult to remove myself from the immediate panic and recognize the obvious signs and symptoms that are being presented.
I also haven't had to perform any sort of differential diagnosis in a true patient setting. Some classmates have had the opportunity to work through an initial evaluation at their clinical sites and apply some of the principles that we're learning in class. As nervous as I know I would be, I think it could be really helpful to be forced to use these tests and diagnostic tools in a real setting. If nothing else, it would make the practical feel like a very controlled, safe environment.