Case scenario for Musculoskeletal Assessment.

Posted: December 23rd, 2022

Case scenario for Musculoskeletal Assessment.


Case scenario for Musculoskeletal Assessment

A 48 year-year old woman who works as a part-time teacher in a daycare center visited the out-patient department due to pain, numbness and tingling in right hand (particularly in the thumb, index and middle fingers) over the last 6 days. These symptoms are felt mostly at night. Insidious onset has started to have difficulty using right hand for gripping and it is starting to affect work as a day care teacher. The pain she felt is getting worse because pain is now extending up the forearm.Case scenario for Musculoskeletal Assessment.


Accordingly, patient was diagnosed with non-insulin-dependent diabetes 5 years ago, currently well controlled with diet and exercise (walks for 45 minutes three times a week and plays social tennis twice a week). She also experienced surgical operation, Knee arthroscopy with partial left medial meniscectomy 12 years ago after tennis injury and recovered well.

Further interview and physical assessment were performed to this patient with the following data:

  • Aggravating factor: Opening jars, packing up play equipment at day care center, sleeping
  • Easing factor: Gets a little relief from changing position and shaking out wrist
  • Daily pattern:Symptoms are dependent on activity. Finds it is painful at end of shift at the day care center.
  • Attitude/expectations:Enjoys her regular exercise (especially playing tennis) so is keen to get the problem fixed
  • Observation:No abnormality detected
  • Palpation:Slight reduction to light touch on the palmar surface of the right thumb and 1st and 2nd finger
  • Movement (right side): wrist flexion = 60°, no pain; Wrist extension = 55°, no pain; Wrist supination = 90° from mid-prone, no pain; Wrist pronation = 90° from mid-prone, no pain; Finger IP flexion OK, no pain; Finger MCP flexion OK, no pain; Thumb flexion, abduction and opposition OK, no pain


  1. Which of the symptoms and signs will you place on your priority list?

I would prioritize pain since the client has complained that it is getting worse and it is extending to the forearm, thus affecting the performance of her daily duties in the day care.


  1. What interview questions would you ask to gather more information?

The interview questions involve the following

  • Is the pain continuous?
  • How would you rate the level of the pain in a scale of 1 to 10?
  • Is the pain uniform or does the severity increase at some point?
  • Have you ever experienced these symptoms before?
  • Do you experience these symptoms in the left hand?
  • Apart from diabetes have been diagnosed with any other critical condition before?
  • Has any member of your family been diagnosed with stroke?

Case scenario for Musculoskeletal Assessment.

  1. Based from the case scenario, please document the findings (use FDAR charting).



Case scenario for Musculoskeletal Assessment.


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