Telemedicine Evaluation of Hip Ailments.

Background During the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has provided new means of patient care while still allowing for physical examination and history to be obtained. Hip ailments are a common musculoskeletal problem leading to limited function. Today, we lack a standardized telemedicine hip evaluation protocol. Aim The aim of this manuscript is to provide an efficient means of extracting relevant information while performing telemedicine examinations of the hip. Methods The authors have created a step-by-step evaluation guide for physicians to evaluate hip complaints, including inspection, palpation, range of motion, strength testing, functional assessment, gait analysis, and special testing, with images of each maneuver. Results  We have developed a table of evaluation questions and instructions and a glossary of images of each maneuver to facilitate hip examination via telemedicine. Conclusions This manuscript provides a structured template for performing a telehealth examination of hip ailments.

Ankle Telemedicine Planning Considerations.

A virtual medical visit, also known as telemedicine or telehealth, is a valuable alternative method of providing health care to patients who do not have easy access to a hospital, or during times when limited social interaction is crucial such as our current COVID-19 pandemic. A virtual approach to evaluating musculoskeletal system ailments is particularly challenging, for diagnosis of these conditions generally rely greatly on physical examination, which may be challenging. However, a properly planned and executed telemedicine visit will yield successful results in most cases. Our aim is to produce a document with instructions and suggestions, including physical examination maneuvers, to help physicians carry out a proper virtual medical visit with patients complaining of ankle musculoskeletal problems. Virtual visits should not be thought of as a replacement for traditional face-to-face medical consultations, but rather a complementary method to provide health care when deemed appropriate. By following this guide, and tailoring it to the specific case at hand, medical providers should be able to effectively carry out a successful telemedicine consultation for musculoskeletal ailments relating to the ankle.Levels of Evidence: Level V.

Telemedicine Examination of the Knee.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has resulted in rapid healthcare system adaptations, including the acceptance of telemedicine in primary care. In the case of knee ailments, among the most common problems encountered in primary care, telemedicine provides a literal window to observe the patient performing functional activities. Despite its potential, there is a lack of standardized protocols for data collection. The purpose of this article is to provide a step-by-step protocol to aid in performing a telemedicine examination of the knee. Methods This article provides a step-by-step guide for a telehealth examination of the knee. Results A step-by-step examination of how to structure a telemedicine evaluation of the knee. A glossary of images of each maneuver has been included to demonstrate the components of the examination. Additionally, a table of questions and possible answers were included to help guide the provider through a knee examination. Conclusion This article provides a structured and efficient means of extracting clinically relevant information during telemedicine examinations of the knee.

Evaluation of the Hand and Wrist via Telephone and Video Visit.

BACKGROUND:  The COVID-19 pandemic has highlighted the utility of telemedicine, with rapid incorporation throughout 2020. Telemedicine is a timely, safe, and effective means of evaluating, triaging, and treating patient conditions, including those of the musculoskeletal system. Hand and wrist complaints are frequently encountered in the primary care setting, and some can have serious consequences if not promptly diagnosed. Prior to the pandemic, over a quarter of the nation's allopathic degree-granting medical schools had initiated telemedicine training as part of the preclinical phase of their curriculum, and about half had implemented it into clerkships prior to the pandemic. Despite rapid acceptance, increased ease of access, and prior attempts to incorporate telemedicine into the educational curriculum, telemedicine evaluation continues to pose challenges to both the patient and provider. This is likely due to a lack of established protocols outlining clinical data collection through a virtual interface. Although telemedicine requires the patient to perform a physical examination, it allows the physician to collect clinically important information while observing the patient in their home environment. AIMS:  The aim of this paper is to provide a step-by-step method to evaluate and triage hand and wrist complaints. METHODS:  Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical hand and wrist examination elements, including inspection, palpation, range of motion (ROM), strength, special, and functional testing. RESULTS:  We have developed a table of evaluation questions and instructions and a glossary of images of each maneuver to facilitate hand and wrist examination via telemedicine. CONCLUSION:  This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the hand.

Telehealth examination of the lumbar spine.

BACKGROUND: Telehealth evaluations of musculoskeletal conditions have increased due to the stay-at-home policies enacted during the COVID-19 pandemic. Back pain is one of the most common complaints in primary care. While telehealth may never supplant in-person evaluation of back pain, it is imperative in a changing world to learn to perform this evaluation via telephone or video. Virtual visits rely on history-taking and patient self-reported descriptions of pain elicited from self-palpation or specific movements while on the telephone with the clinician. Video examinations provide a unique way of evaluating the lower back compared to telephone because of the ability to visualize the actions of the patient. OBJECTIVE: To create an evaluation pathway for examination of the lumbar spine via telehealth. METHODS: Our group has created a step-by-step evaluation pathway to help physicians direct their patients through typical lumbar examination elements, including inspection, palpation, range of motion, and strength, special, and functional testing. RESULTS: We have developed a table of questions and instructions and a glossary of images of each maneuver to facilitate lumbar spine examination via telemedicine. CONCLUSIONS: This paper provides a guide for extracting clinically relevant information while performing telemedicine examinations of the lumbar spine.

Foot evaluation via telephone and video virtual medical visits.

BACKGROUND: Telemedicine plays a very important role in our society by allowing providers to treat patients who do not have easy access to a healthcare facility, especially in the setting of the COVID-19 pandemic. OBJECTIVE: We aimed to create an extensive, yet concise guide for medical providers to virtually evaluate patients with foot concerns. METHODS: This article outlines how to conduct a well-planned virtual consultation with specific questions, instructions, and examination manoeuvres to navigate musculoskeletal foot problems. CONCLUSION: With this narrative review, we have provided a guide with suggestions, questions and interpretations of answers to help physicians new to the practice of telemedicine have successful virtual encounters with patients suffering from foot musculoskeletal ailments.