Case Study 1: Physical examination
The student now begins the physical examination.
Note how the student is obtaining consent at each step and explaining the next procedure.
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Student: So Mr Bearay you have already told me about your charcot feet and how they have already collapsed in, would you mind if I watched you walk up and down a few times to see what it looks like for me, do you mind if you roll your pants up to above your ankles
Lloyd: in conducting the physical examination, notice the way the student is explaining what he would like to do, ensuring that the patient is informed about what is going to take place. At each part of the process, consent is obtained before proceeding.
Mr Bearay in shoes:Student: so if you don't mind just standing up by the door for me - and then walk a few laps for me if you don't mind - so if you just come to me and then turn around and back to the wall - That's great. - Just a few more times if you don't mind.
Student: If you don't mind walking towards me again - and back - That's great - Just a few more times
Mr Bearay barefoot:Student: So before we get you walking do you mind if I just have a look at you standing if thats okay - so if you don't mind standing and facing the wall there for me - that's great - do you mind turning and facing me.
Studenty: Now if you don't mind taking a few steps toward me and then turning around
Lloyd: Performing the stance and walking examinations is an important part of a podiatric examination. Some of the key observations in this visual gait analysis were:
- Collapse of the arch of the foot bilaterally
- Distortion of the medial side of the shoes
- Early heel lift and avoidance of heel contact especially on the left foot
- Toe deformities with some toes non-function in standing and gait
