http://www.jospt.org/toddedavenport Wed, 30 Apr 2008 09:05:25 EST 0 http://www.jospt.org/issues/articleID.1416/article_detail.asp The patient was a 44-year-old male with a 5-month history of lumbar radiculopathy following a golf injury. Following magnetic resonance imaging, he received a spinal epidural injection consisting of corticosteriods from his spine surgeon 2 weeks prior to physical therapy evaluation. Five weeks postinjection, the patient noted a progressive and significant worsening of his local lumbar and radicular symptoms. Magnetic resonance imaging revealed a lumbar subcutaneous abscess, for which the patient underwent open debridement and intravenous antibiotic therapy for methicillin sensitive staphylococcus aureus. He subsequently returned to physical therapy for successful management of his residual disablement.J Orthop Sports Phys Ther., 2008;38(5):287. doi:10.2519/jospt.2008.0405KEY WORDS: infection, magnetic resonance imaging, staphylococcus aureus http://www.jospt.org/issues/articleID.1416/article_detail.asp http://www.jospt.org/issues/articleID.804/article_detail.asp Study Design: Randomized multicenter retrospective chart review of medical referral diagnoses and corresponding referral, patient, and physician demographic data. Objective: To examine the information content of medical referral diagnoses provided to outpatient physical therapists with respect to physician and patient characteristics. Background: Previous studies indicate that physicians commonly provide nonspecific referral diagnoses to physical therapists. The effects of patient and physician characteristics on information contained in referral diagnoses are not well elucidated. Methods and Measures: A team of blinded raters categorized the information content of referral diagnoses (n = 2183) using a classification system adapted from a previous study. Results: One third (32%) of analyzed diagnoses were anatomically oriented and reported specific pathology. These specific diagnoses were provided significantly more commonly by specialist physicians (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.7-4.2; P Conclusion: Physicians frequently provide nonspecific referral diagnoses to physical therapists. The practice of evidence-based physical therapy seems challenged by the high rate of nonspecific referral diagnoses. Physical therapists may also have the responsibility to conduct differential diagnosis of pathology more commonly than formally recognized by many state practice acts and third-party payers. J Orthop Sports Phys Ther. 2005;35(9):572-579. Key Words: differential diagnosis, direct access, primary care http://www.jospt.org/issues/articleID.804/article_detail.asp http://www.jospt.org/issues/articleID.1002/article_detail.asp http://www.jospt.org/issues/articleID.1002/article_detail.asp