Physical therapy
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This case report describes the treatment of a patient who had symptoms and signs suggestive of a sacroiliac joint component of low back pain. The patient developed right-sided low back pain without provocation. ⋯ After treating the sacroiliac joint and restoring symmetrical hip rotation, the patient no longer complained of low back pain. This case report suggests that asymmetrical hip rotation may contribute to what is often called a sacroiliac joint component of low back pain.
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Clinical reasoning refers to the cognitive process or thinking used in the evaluation and management of a patient. In this article, clinical reasoning research and expert-novice studies are examined to provide insight into the growing understanding of clinical reasoning and the nature of expertise. Although hypothetico-deductive methods of reasoning are used by clinicians at all levels of experience, experts appear to possess a superior organization of knowledge. ⋯ Five categories of hypotheses are proposed for physical therapists using a hypothetico-deductive method of clinical reasoning. A model of the clinical reasoning process for physical therapists is presented to bring attention to the hypothesis generation, testing, and modification that I feel should take place through all aspects of the patient encounter. Examples of common errors in clinical reasoning are highlighted, and suggestions for facilitating clinical reasoning in our students are made.