Masqueraders: 3 MSK Case Studies

I was fortunate enough to be studying for my postgraduate musculoskeletal physiotherapy degree in Perth, in 1992 at Curtin University under the clinical guidance of Bob Elvey, when Gregory Grieve editor of Modern Manual Medicine visited. He presented on this topic and raised my awareness that as a young clinician and primary contact practitioner, there is a strong possibility of seeing tumours in my day-to-day clinical practice.

Less than 5% of primary care physicians routinely examine for red flags during their initial screen and in 160 cases, 96% of physical therapists examined 64% of 11 red flag questions but routinely didn’t ask about weight loss 2.

Back-of-the-envelope calculations indicate that if you see on average 3 new clients per day, and have 4 weeks of holiday a year, you will be seeing on average 5 people a year who will be newly diagnosed with cancer in that year.

The often-masked aspect of a tumour presenting as musculoskeletal presentation is an important aspect to be continually alert about. I hope this eBook helps stimulate that awareness in you, as did Greg Grieve’s presentation for me.

Dr Doug Cary PhD

MSK Physiotherapy Specialist (conferred Aust Physio Council 2009)