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1DVBCWHT1 ;ALB/CMM HAND, THUMB, FINGERS WKS TEXT - 1 ; 6 MARCH 1997
2 ;;2.7;AMIE;**12**;Apr 10, 1995
3 ;
4 ;
5TXT ;
6 ;;A. Review of Medical Records:
7 ;;
8 ;;
9 ;;
10 ;;B. Medical History (Subjective Complaints):
11 ;;
12 ;; Comment on:
13 ;; 1. If there are periods of flare-up of joint disease:
14 ;; a. State their severity, frequency, and duration.
15 ;;
16 ;;
17 ;; b. Name the precipitating and alleviating factors.
18 ;;
19 ;;
20 ;; c. Estimate to what extent, if any, they result in additional
21 ;; limitation of motion or functional impairment during the flare-up.
22 ;;
23 ;;
24 ;;C. Physical Examination (Objective Findings):
25 ;;
26 ;; Address each of the following as appropriate to the condition being
27 ;; examined and full describe current findings:
28 ;; 1. Anatomical defects.
29 ;;
30 ;;
31 ;; 2. Functional defects (motion of thumb and fingers should be
32 ;; described as to how near, in inches, the tip of thumb can
33 ;; approximate the fingers, or how near the tips of fingers can
34 ;; approximate the median transverse fold of the palm.
35 ;;
36 ;;
37 ;; 3. Grasping objects (strength and dexterity).
38 ;;
39 ;;
40 ;;The hand should be evaluated as a unit intricately adapted for grasping,
41 ;;pushing, pulling, twisting, probing, writing, touching, and expression.
42 ;;Do not designate fingers numerically; use thumb, index, middle (or
43 ;;long), ring, and little. Specify which hand is involved and state
44 ;;whether the individual is right- or left-handed. Designate the joints
45 ;;as wrist, MP (metacarpophalangeal), PIP (proximal interphalangeal), or
46 ;;DIP (distal interphalangeal). Designate phalanges as proximal, middle
47 ;;or distal.
48 ;;
49 ;;TOF
50 ;; 4. A detailed assessment of each affected joint is required.
51 ;; a. Using a goniometer, measure the PASSIVE and ACTIVE range
52 ;; of motion, including movement against gravity and against
53 ;; strong resistance.
54 ;;
55 ;;
56 ;; b. State to what extent (if any) and in which degrees (if
57 ;; possible) the range of motion or joint function is
58 ;; ADDITIONALLY LIMITED by pain, fatigue, weakness, or lack
59 ;; of endurance following repetitive use or during flare-ups.
60 ;; If more than one of these is present, state, if possible,
61 ;; which has the major functional impact.
62 ;;
63 ;;
64 ;;D. Diagnostic and Clinical Tests:
65 ;;
66 ;; 1. Include results of all diagnostic and clinical tests conducte
67 ;; in the examination report.
68 ;;
69 ;;
70 ;;E. Diagnosis:
71 ;;
72 ;;
73 ;;Signature: Date:
74 ;;END
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