Differential Diagnosis & Medical Screening

Location: OSPTA Corporate Office

Address: 4325 SR51 North, Belle Vernon, PA 15012

Date: 26 Oct

CEUs: 13.25

Course Description

This course is designed to teach physical therapists methods for identifying potential medical conditions that may require medical referral. This course will help increase the clinician’s confidence during the evaluation process and assist in diagnostic accuracy. Evidence-based screening tools with be covered along with learning “red flags” for a variety of conditions and body systems. Other subjects to be covered include heart and lung screening exam along with understanding normal and abnormal vital signs and their response to exercise, abdominal screening exam and related special tests, basics of imaging and its role in the differential diagnosis process, review of the upper and lower quarter screening exam along with a cranial nerve and neurologic screen, skin screening exam, psychological considerations, and finally pharmacologic considerations including medicine side effects of commonly prescribed medications seen in the physical therapy settings. The presentation of this course material will provide the physical therapists with the knowledge required to see patients via direct access and allow them to understand potential medical conditions that require referral.

Course Objectives

1. Present an overview of the role of the physical therapist as it pertains to direct access and differential diagnosis.

2. Relay the importance of a comprehensive history taking in efforts to identify “red flags” that may indicate the presence of potential serious medical conditions.

3. Review and understand the clinical significance of vital signs and the normal vs. pathophysiologic changes seen with exercise.

4. Review and learn examination skills for major body systems including skin, cardiopulmonary, abdominal, musculoskeletal, neurological and psychological.

5. Recognize the indications for commonly prescribed diagnostic tests and their clinical significances.

6. Discuss pertinent pharmacologic issues including commonly used medications, side effects, and potential interactions of physical therapy treatments with the medications.

7. Use case studies to highlight clinical decision making processes in the cases involving the initiation of treatment versus medical referral.

8. Utilize lab time to instruct and practice screening exams for the trunk (heart/lung/abdominal) including inspection, percussion, palpation, auscultation, and special tests, and performance of upper limb and lower limb tension tests.

Presenters Bios:

Daniel Higgins:

Daniel W. Higgins, Jr., PT, DPT, OCS, ATC has been practicing in the Physical Therapy and Athletic Training fields combined for over 20 years. He is a licensed PT with a board certification in orthopedics through the American Board of Physical Therapy Specialties, and a certified athletic trainer. Dan is a 1995 graduate from Duquesne University with a Bachelor’s of Science degree in Athletic Training. He then graduated from Chatham University with a Masters in Physical Therapy followed by a Doctorate in Physical Therapy in 2002.

Dan began his career as a certified athletic trainer in which he worked in multiple settings ranging from college and high school athletic teams to the physical therapy clinical setting. Currently, he works as a staff physical therapist with the private outpatient practice of Orthopedic & Sports Physical Therapy Associates, Inc. (OSPTA) in western Pennsylvania, where he holds the position of direct access coordinator and continuing education coordinator for the staff of approximately 45 physical therapists.

With his combined specialization in orthopedic physical therapy and athletic training, evaluating and treating musculoskeletal injuries has always been a focus of Dan’s career. This experience has prepared him to present on the topics of differential diagnosis and medical screening.

Mark Kerestan:

Mark Kerestan was born in southwestern Pennsylvania and has lived and worked there for most of his life. He attended Alderson-Broaddus College in West Virginia and graduated Magna Cum Laude with a B.S. degree in Medical Science in 1984 (Physician Assistant program). Upon successful completion of the National Certification Examination, Mr. Kerestan began his professional career working in correctional medicine and public health.

While working as a Physician Assistant with the Supplemental Security Income-Disabled Children’s Program, Mr. Kerestan decided to pursue a degree in Physical Therapy. He entered the University of Pittsburgh and in 1987 was the recipient of the George and Eileen McHenry Scholarship awarded to a physical therapy student showing “a sincere interest and determination to make a significant contribution to the field of physical therapy”. He graduated Summa Cum Laude from the University of Pittsburgh in 1988 with a B.S. degree in Physical Therapy.

After starting his career at Jeannette District Memorial Hospital, Mr. Kerestan has worked for Orthopedic Sports and Physical Therapy Associates (OSPTA), a group of private practices in southwestern, PA for over 25 years. His practice emphasis has been on Work Injury Management and he has attended courses by Blankenship, Isernhagen, Matheson, and Lechner. He is certified to perform the Ergoscience Physical Work Performance Evaluation (FCE system) and is a Certified Ergonomic Assessment Specialist through the Back School of Atlanta. For the past 8 years OSPTA has been contracted as the PT panel provider for United States Steel Corporation, and Mr. Kerestan has been the primary contract consultant to U. S. Steel.

Mr. Kerestan did a research study on “Work Conditioning Return to Work Outcomes at an Outpatient Physical Therapy Office” which was published in the Orthopaedic Physical Therapy Practice journal and as a poster presentation at the Pennsylvania Physical Therapy Association Annual Conference in 1995. In 2009, Mr. Kerestan, along with Daniel Higgins, developed a continuing education course on Differential Diagnosis and Medical Screening for PTs, OTs and ATCs that

has been presented at clinics across the US. Additionally he has made numerous presentations on a variety of injury prevention and health awareness topics to workers in the health care, steel production, utilities, and chemical processing industries.