Netter’s Orthopaedic Clinical Examination – An Evidence-Based Approach 3rd Edition PDF

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Preface

Over the past several years evidence-based practice has become the standard in the medical and healthcare professions. As described by Sackett and colleagues (Evidence-Based Medicine: How to Practice and Teach EBM, 2nd ed, London, 2000, Harcourt Publishers Limited), evidence-based practice is a combination of three elements: the best available evidence, clinical experience, and patient values. Sackett has further reported that “when these three elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance which optimizes clinical outcomes and quality of life.” Each element contributes significantly to the clinical reasoning process by helping to identify a diagnosis or prognosis or establish an effective and efficient plan of care. Unfortunately, the evidence-based approach confronts a number of barriers that may limit the clinician’s ability to use the best available evidence to guide decisions about patient care, most significantly a lack of time and resources. Given the increasing prevalence of new clinical tests in the orthopaedic setting and the frequent omission from textbooks of information about their diagnostic utility, the need was clear for a quick reference guide for students and busy clinicians that would enhance their ability to incorporate evidence into clinical decision making.
The purpose of Netter’s Orthopaedic Clinical Examination: An Evidence-Based Approach is twofold: to serve as a textbook for musculoskeletal evaluation courses in an academic setting and to provide a quick, user-friendly guide and reference for clinicians who want to locate the evidence related to the diagnostic utility of commonly utilized tests and measures.
The first chapter is intended to introduce the reader to the essential concepts underlying evidence-based practice, including the statistical methods it employs and the critical analysis of research articles. The remainder of the book consists of chapters devoted to individual body regions. Each chapter begins with a review of the relevant osteology, arthrology, myology, and neurology and is liberally illustrated with images by the well-known medical artist Frank H. Netter, MD. The second portion of each chapter provides information related to patient complaints and physical examination findings. Reliability and diagnostic utility estimates (sensitivity, specificity, and likelihood ratios) are presented for each patient complaint and physical examination finding and are accompanied by quick access interpretation guides. Test descriptions and definitions of positive test findings are included as reported by the original study authors, both to minimize any alteration of information and to provide readers insight into difference values reported by different studies. At the end of each chapter are tables listing information on commonly used outcome measures and quality ratings for all the studies investigating tests’ diagnostic utility. For this new edition, we’ve also included quality ratings for all the studies investigating tests’ reliability. Additionally, new video content demonstrating select tests from each body region can be accessed online.
We hope that clinicians will find Netter’s Orthopaedic Clinical Examination a user-friendly clinical resource for determining the relevance of findings from the orthopaedic examination. We also hope that students and educators will find this a valuable guide to incorporate into courses related to musculoskeletal evaluation and treatment.

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