When doctors forget how to examine: the danger of lost clinical skills
An older woman with osteoporosis fell at home, developed back pain, then went to urgent care and was diagnosed with a “muscle strain.” During a follow-up visit in my office, she told me she’d had transient urinary incontinence after her fall, and on exam she had midline back tenderness, hip flexor weakness, and hyper-reflexive knee jerks. This woman had suffered a vertebral fracture, not a pulled muscle.
One of my patients …