DVBCWFW1.m

DVBCWFW1 ;ALB/CMM FEET WKS TEXT - 1 ; 6 MARCH 1997

 ;;2.7;AMIE;**12**;Apr 10, 1995

 ;

 ;

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.  Describe symptoms at 

 ;;        rest and on standing and walking.

 ;;

 ;;

 ;;    2.  Treatment - type, dose, frequency, response, side effects.

 ;;

 ;;

 ;;    3.  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.

 ;;

 ;;

 ;;    4.  Describe whether crutches, brace, cane, corrective shoes, 

 ;;        etc., are needed.

 ;;

 ;;

 ;;    5.  Describe details of any surgery or injury.

 ;;

 ;;

 ;;    6.  Describe corrective shoes, shoe inserts, or braces used and 

 ;;        their efficacy.

 ;;

 ;;

 ;;    7.  Describe effects of the condition(s) on the veteran's usual 

 ;;        occupation and daily activities.

 ;;

 ;;TOF

 ;;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.  Using a goniometer, measure the PASSIVE and ACTIVE range of 

 ;;        motion, including movement against gravity and against strong

 ;;        resistance.

 ;;

 ;;

 ;;    3.  If the joint is painful on motion, state at what point in the

 ;;        range of motion pain begins and ends.

 ;;

 ;;

 ;;    4.  State to what extent (if any) and in which degrees (if possible) 

 ;;        the range of motion or function is ADDITIONALLY LIMITED by 

 ;;        pain, fatigue, weakness, or lack of endurance following 

 ;;        repetitive use or during flare-ups.  If more than one of these

 ;;        is present, state, if possible, which has the major functional

 ;;        impact.

 ;;

 ;;

 ;;    5.  Describe objective evidence of painful motion, edema, 

 ;;        instability, weakness, tenderness, etc.

 ;;

 ;;

 ;;    6.  Describe gait and functional limitations on standing and walking.

 ;;

 ;;

 ;;    7.  Describe any callosities, breakdown, or unusual shoe wear 

 ;;        pattern that would indicate abnormal weight bearing.

 ;;

 ;;

 ;;    8.  Describe any skin and vascular changes.

 ;;

 ;;

 ;;    9.  Posture on standing, squatting, supination, pronation, and 

 ;;        rising on toes and heels.

 ;;

 ;;

 ;;   10.  Describe hammertoes, high arch, clawfoot, or other deformity -

 ;;        actively or passively correctable?

 ;;

 ;;

 ;;   11.  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.

 ;;

 ;;

 ;;   12.  For hallux valgus, describe angulation and dorsiflexion at 

 ;;        first metatarsal phalangeal joints.  

 ;;

 ;;

 ;;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.

 ;;    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

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---DVBCWFW1   4436     printed  Apr 23, 2025@18:05:43                                                                                                                                                                                                    Page 2

DVBCWFW1  ;ALB/CMM FEET WKS TEXT - 1 ; 6 MARCH 1997

 +1       ;;2.7;AMIE;**12**;Apr 10, 1995

 +2       ;

 +3       ;

TXT       ;

 +1       ;;A.  Review of Medical Records:

 +2       ;;

 +3       ;;

 +4       ;;

 +5       ;;B.  Medical History (Subjective Complaints):

 +6       ;;

 +7       ;;    Comment on:

 +8       ;;    1.  Pain, weakness, stiffness, swelling, heat, redness, 

 +9       ;;        fatigability, lack of endurance, etc.  Describe symptoms at 

 +10      ;;        rest and on standing and walking.

 +11      ;;

 +12      ;;

 +13      ;;    2.  Treatment - type, dose, frequency, response, side effects.

 +14      ;;

 +15      ;;

 +16      ;;    3.  If there are periods of flare-up of joint disease:

 +17      ;;        a.  State their severity, frequency, and duration.

 +18      ;;

 +19      ;;

 +20      ;;        b.  Name the precipitating and alleviating factors.

 +21      ;;

 +22      ;;

 +23      ;;        c.  Estimate to what extent, if any, they result in additional

 +24      ;;            limitation of motion or functional impairment during the 

 +25      ;;            flare-up.

 +26      ;;

 +27      ;;

 +28      ;;    4.  Describe whether crutches, brace, cane, corrective shoes, 

 +29      ;;        etc., are needed.

 +30      ;;

 +31      ;;

 +32      ;;    5.  Describe details of any surgery or injury.

 +33      ;;

 +34      ;;

 +35      ;;    6.  Describe corrective shoes, shoe inserts, or braces used and 

 +36      ;;        their efficacy.

 +37      ;;

 +38      ;;

 +39      ;;    7.  Describe effects of the condition(s) on the veteran's usual 

 +40      ;;        occupation and daily activities.

 +41      ;;

 +42      ;;TOF

 +43      ;;C.  Physical Examination (Objective Findings):

 +44      ;;

 +45      ;;    Address each of the following as appropriate to the condition 

 +46      ;;    being examined and fully describe current findings:  A DETAILED 

 +47      ;;    ASSESSMENT OF EACH AFFECTED JOINT IS REQUIRED.

 +48      ;;

 +49      ;;    1.  Describe each foot separately.  For nomenclature of toes use:

 +50      ;;        great toe, second, third, fourth, and fifth.  The functional 

 +51      ;;        loss should be related to the anatomical condition.

 +52      ;;

 +53      ;;

 +54      ;;    2.  Using a goniometer, measure the PASSIVE and ACTIVE range of 

 +55      ;;        motion, including movement against gravity and against strong

 +56      ;;        resistance.

 +57      ;;

 +58      ;;

 +59      ;;    3.  If the joint is painful on motion, state at what point in the

 +60      ;;        range of motion pain begins and ends.

 +61      ;;

 +62      ;;

 +63      ;;    4.  State to what extent (if any) and in which degrees (if possible) 

 +64      ;;        the range of motion or function is ADDITIONALLY LIMITED by 

 +65      ;;        pain, fatigue, weakness, or lack of endurance following 

 +66      ;;        repetitive use or during flare-ups.  If more than one of these

 +67      ;;        is present, state, if possible, which has the major functional

 +68      ;;        impact.

 +69      ;;

 +70      ;;

 +71      ;;    5.  Describe objective evidence of painful motion, edema, 

 +72      ;;        instability, weakness, tenderness, etc.

 +73      ;;

 +74      ;;

 +75      ;;    6.  Describe gait and functional limitations on standing and walking.

 +76      ;;

 +77      ;;

 +78      ;;    7.  Describe any callosities, breakdown, or unusual shoe wear 

 +79      ;;        pattern that would indicate abnormal weight bearing.

 +80      ;;

 +81      ;;

 +82      ;;    8.  Describe any skin and vascular changes.

 +83      ;;

 +84      ;;

 +85      ;;    9.  Posture on standing, squatting, supination, pronation, and 

 +86      ;;        rising on toes and heels.

 +87      ;;

 +88      ;;

 +89      ;;   10.  Describe hammertoes, high arch, clawfoot, or other deformity -

 +90      ;;        actively or passively correctable?

 +91      ;;

 +92      ;;

 +93      ;;   11.  For flatfoot

 +94      ;;        a.  Describe weight bearing and non-weight bearing alignment 

 +95      ;;            of the Achilles tendon.

 +96      ;;

 +97      ;;

 +98      ;;        b.  Describe whether the Achilles tendon alignment can be 

 +99      ;;            corrected by manipulation and whether there is pain on 

 +100     ;;            manipulation.

 +101     ;;

 +102     ;;

 +103     ;;        c.  Describe degrees of valgus and whether correctable by 

 +104     ;;            manipulation.

 +105     ;;

 +106     ;;

 +107     ;;        d.  Describe extent of forefoot and midfoot malalignment and 

 +108     ;;            whether correctable by manipulation.

 +109     ;;

 +110     ;;

 +111     ;;   12.  For hallux valgus, describe angulation and dorsiflexion at 

 +112     ;;        first metatarsal phalangeal joints.  

 +113     ;;

 +114     ;;

 +115     ;;D.  Diagnostic and Clinical Tests:

 +116     ;;

 +117     ;;    Comment on:

 +118     ;;    1.  X-rays for flatfoot and clawfoot - weight bearing AP and 

 +119     ;;        lateral views and non-weight bearing AP, lateral, and oblique

 +120     ;;        views.

 +121     ;;    2.  For other conditions, AP, lateral, and oblique of entire foot,

 +122     ;;        as applicable.

 +123     ;;    3.  Include results of all diagnostic and clinical tests conducted

 +124     ;;        in the examination report.

 +125     ;;

 +126     ;;

 +127     ;;E.  Diagnosis:

 +128     ;;

 +129     ;;

 +130     ;;Signature:                             Date:

 +131     ;;END