5. Abnormal findings

Abnormal findings are charted as a chain — finding, severity, comparison to baseline, the risk it creates, and the skilled action taken.

• New or increasing weakness on manual muscle testing versus baseline — raising fall and disuse risk and limiting function.
• New loss of range of motion, or a hip moved or held outside its precaution — risking dislocation or contracture.
• New gait instability, near-falls, or an unsafe transfer — increasing fall and injury risk.
• A new hot, swollen, or effused joint, with or without fever — concerning for septic arthritis or acute inflammation.
• Sudden severe pain after a fall with deformity, shortening, or inability to bear weight — concerning for fracture.
• Pain out of proportion with pallor, paresthesia, pulselessness, or a tense compartment — concerning for compartment syndrome.
• New back pain with bowel or bladder change or saddle anesthesia — concerning for cauda equina syndrome.
• Post-operative hip with sudden pain, shortening, rotation, or a “pop” — concerning for prosthetic dislocation.