The Trojan HORSE of Physical Examination
There are numerous strategies a clinician can utilize to plan out and execute a thorough physical examination. In an effort to be more efficient clinically, I have widdled down a combination of methods to formulate the "HORSE" mnemonic.
The "HORSE" mnemonic is a simplified means of assessing a patient's injury from start to finish. The sequence is as follows:
H - History of present illness
O - Observation/Inspection
R - Range of motion
S - Special tests
E - Explore/Palpate
In most cases, a thorough history ("H") will give the clinician enough information to recognize key features of particular patterns. In this sense, the subjective exam is a valuable asset. The objective exam ("ORSE") is essential in ruling in or out possibilities that may often overlap and will assist the clinican in confirming their working diagnosis. When utilized, the clinician's assessment skills become more refined leading to treatment approaches which are more precise.
Like a Trojan Horse, there is something hidden behind the walls of the body which the clinican is trying to detect. To find the hidden diagnosis, the clinican will need to be a real work horse to become skilled at all of the multiple facets listed in the HORSE mnemonic.