Suboccipital Pain Following a Basketball Head Injury

A Case Scenario to Sharpen Your Diagnostic Skills

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To enhance your diagnostic reasoning skills, follow these steps:

  • Review the Information: Carefully read through the content in each section of the case scenario.
  • Consider the Question: Reflect on the Diagnostic Reasoning Question presented. Take your time to think about your answer.
  • Compare Your Answer: Attempt to answer the question before viewing our suggested answer. When ready, click “View Suggested Answer” to compare it with your own.

Repeat these steps for each section of the case scenario. Please note that the suggested answers are only indicative and not exhaustive. They serve as guidelines and should not be considered complete answers.

Patient’s History

In the sections below, you will find case history information designed to guide you through a systematic approach to performing a focused and relevant case history. This process will help you narrow down the potential causes of the patient’s complaint. As you go through the material, we encourage you to answer the questions provided to test and enhance your diagnostic reasoning skills.

Who is the patient and where is the pain?
When was the onset and what caused the onset?

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Diagnostic Reasoning Question

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What are the pain characteristics?
What are the aggravating and relieving factors?
What has been the course of the pain?

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Diagnostic Reasoning Question

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Are there any associated symptoms?

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Diagnostic Reasoning Question

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Is there any past history that may be relevant to the current complaint?

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Diagnostic Reasoning Question

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Are there any red flags?

The following questions are asked to identify any “red flags” that could suggest serious pathology. Even if the patient has previously mentioned related information during the case history, it is recommended to revisit these questions to ensure a comprehensive evaluation.

  • Does your pain disappear even for a short time? “???????.”

Diagnostic Reasoning Question

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Differential Diagnosis

Diagnostic Reasoning Question

Based on the available history, how would you prioritize the list of differential diagnoses?

Reflection Point

Pause and consider whether the key elements of a thorough and relevant patient history have been addressed. Are there any additional questions you would have asked? If so, what are they, and why would they be important?

Before reviewing the physical examination findings below, take a moment to reflect on which physical examination procedures you would perform to accurately assess this patient.

Physical Examination

In the sections below, you will find physical examination findings for this patient. The material outlines a systematic approach to conducting a focused and relevant physical examination aimed at narrowing down the potential causes of the patient’s complaint. As you review the material, we encourage you to answer the questions provided to test and enhance your clinical reasoning and diagnostic skills. Additionally, consider whether all essential elements of the physical examination have been thoroughly addressed.

Vital Signs

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Diagnostic Reasoning Question

What is the significance of normal vital signs?

Inspection

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Diagnostic Reasoning Question

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Range of Motion

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Diagnostic Reasoning Question

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Palpation

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Diagnostic Reasoning Question 1

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Diagnostic Reasoning Question 2

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Neurological Examination

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Diagnostic Reasoning Question

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Reflection Point

Considering the patient’s history and examination findings thus far, take a moment to reflect on which special tests would be most appropriate to further evaluate this patient.

Special Tests

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Diagnostic Reasoning Question

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Diagnostic Reasoning Question

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Diagnostic Reasoning Question

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Diagnostic Reasoning Question

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Diagnostic Reasoning Question

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Diagnostic Reasoning Question

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Reflection Point

Please pause and assess whether all the essential elements of a thorough and relevant physical examination have been completed for this patient. Are there any additional procedures you would have performed? If so, why?

Imaging

Text for Imaging

Diagnosis

Diagnostic Reasoning Question

Based on the available information, what is the most likely diagnosis?

References and Suggested Further Readings
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Review Quiz

1. What is 2+2?

Disclaimer:  The acemsk.com website (including text, graphics, downloadable resources, and videos) is intended to provide general health information for educational purposes only. This information is not a substitute for personal consultation with a qualified healthcare professional. Always seek the advice of a healthcare professional for any questions regarding your condition, symptoms, and appropriate treatments.

Copyright © Educom Pty Ltd:  All content on the acemsk.com website, including text, graphics, videos, and downloadable files, is the property of Educom Continuing Education, a division of Educom Pty Ltd, and is protected by copyright and other intellectual property laws under international conventions. Unauthorized use or duplication of this material without express written permission from Educom Pty Ltd is strictly prohibited.

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