Pennsylvania Physical Therapy Ebook Continuing Education

Differential Diagnosis for Physical Therapy: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary 129

• Diarrhea or constipation • Fecal incontinence • Skin rash followed by joint pain (Crohn's disease) Guidelines for Immediate Medical Attention • Anytime appendicitis or iliopsoas/ obturator abscess is suspected • Positive Kehr's sign: Acute pain in shoulder due to the presence of blood or other irritants in peritoneal cavity when lying down and legs are elevated Guidelines for Physician Referral • Clients who chronically rely on laxatives should be encouraged to discuss bowel management with their physician • Joint involvement accompanied by skin or eye lesions may be reflective of IBD and should be reported to the physician if they are unaware of these manifestations

• Anyone with history of NSAID use presenting with back or shoulder pain, especially when accompanied by any associated signs and symptoms listed for peptic ulcer • Back pain associated with meals or relieved by a bowel movement (especially if accompanied by rectal bleeding) • Back pain of unknown cause that does not fit a musculoskeletal pattern

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