VistA-FOIAVistA/r/AUTOMATED_MED_INFO_EXCHANGE.../DVBCWFW3.m

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DVBCWFW3 ;ALB/RLC FEET WKS TEXT - 1 ; 16 JAN 2007
;;2.7;AMIE;**120**;Apr 10, 1995;Build 4
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on:
;;
;; 1. Pain, weakness, stiffness, swelling, heat, redness,
;; fatigability, lack of endurance, etc.
;; 2. Describe symptoms at rest and on standing and walking.
;; 3. Treatment - type, dose, frequency, response, side effects.
;; 4. If there are periods of flare-up of joint disease:
;;
;; a. State their severity, frequency, and duration.
;; b. Name the precipitating and alleviating factors.
;; c. Estimate to what extent, if any, they result in additional
;; limitation of motion or functional impairment during the
;; flare-up. (Per veteran)
;;
;;
;; 5. Describe whether crutches, brace, cane, corrective shoes,
;; shoe inserts, etc., are needed and their efficacy.
;; 6. History of any hospitalization or surgery (Date, location, if known,
;; reason or type of surgery).
;; 7. Describe effects of the condition(s) on the veteran's usual
;; occupation and daily activities.
;; 8. Describe any injury to the feet.
;; 9. Functional limitations on standing (i.e., unable to stand, able
;; to stand 15-30 minutes) and walking (i.e., nonambulatory, able to
;; walk 1/4 mile).
;; 10. History of neoplasm:
;;
;; a. Date of diagnosis, diagnosis.
;; b. Benign or malignant.
;; c. Types and dates of treatment.
;; d. Date of last treatment.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following as appropriate to the condition
;; being examined and fully describe current findings: A DETAILED
;; ASSESSMENT OF EACH AFFECTED JOINT IS REQUIRED.
;;
;; 1. Describe each foot separately. For nomenclature of toes use:
;; great toe, second, third, fourth, and fifth. The functional
;; loss should be related to the anatomical condition.
;; 2. Describe objective evidence of painful motion, edema,
;; instability, weakness, tenderness, etc.
;; 3. Describe gait.
;; 4. Describe any callosities, breakdown, or unusual shoe wear
;; pattern that would indicate abnormal weight bearing.
;; 5. Describe any skin and vascular changes.
;; 6. Describe hammertoes, high arch, clawfoot, or other deformity -
;; actively or passively correctable?
;; 7. For flatfoot
;;
;; a. Describe weight bearing and non-weight bearing alignment
;; of the Achilles tendon.
;; b. Describe whether the Achilles tendon alignment can be
;; corrected by manipulation and whether there is pain on
;; manipulation.
;; c. Describe degrees of valgus and whether correctable by
;; manipulation.
;; d. Describe extent of forefoot and midfoot malalignment and
;; whether correctable by manipulation.
;;
;; 8. For hallux valgus, describe angulation and dorsiflexion at
;; first metatarsal phalangeal joints.
;; 9. Is there any active motion in the metatarsophalangeal joint of
;; the great toe?
;;
;;D. Diagnostic and Clinical Tests:
;;
;; Comment on:
;;
;; 1. X-rays for flatfoot and clawfoot - weight bearing AP and
;; lateral views and non-weight bearing AP, lateral, and oblique
;; views, if none are of record or if of record and condition has or
;; may have progressed.
;; 2. For other conditions, AP, lateral, and oblique of entire foot,
;; as applicable.
;; 3. Include results of all diagnostic and clinical tests conducted
;; in the examination report.
;;
;;E. Diagnosis:
;;
;;
;;Signature: Date:
;;END