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Subjective
Chief complaint of bunion(s)- which side?
HPI: Had bunion which side?
Duration
The bunion(s) on the?
has been painful for
Onset
• • •
Course:
Precipitating event
• • •
Comments
The pain is present
Previous episode: Denies
Previous episode:
PMH:
Objective
Dorsalis pedis pulses are- Right
left
tibial pulses are graded at- right
Left
Digital hair growth is- Right
Left
CFT with the leg elevated- Right
Left
Evidence of ischemic skin changes?
Temperature, Texture, Turgor is
Rom of the motion- WNL
• • •
bunion deformity present on the right foot
pain with palpation- of the 1st metatarsal?
hypermotility of the first ray noted?
pain with palpation?
pain with palpation of the?
• • •
There is normal ROM?
degrees of DF
degrees of PF
tracking or track bound motion?
Range of motion of the 1st MPJ is
• • •
crepitus present?
bunion deformity present on the left foot
pain with palpation- of the 1st metatarsal?
hypermotility of the first ray noted?
pain with palpation?
pain with palpation of the?
• • •
There is normal ROM?
degrees of DF
degrees of PF
tracking or track bound motion?
Range of motion of the 1st MPJ is
• • •
crepitus present?
negative Tinel's sign over
• • •
Which Side
Please select
• • •
Assessment
Bunion with
• • •
Plan
Plan
• • •
Discussed with
What was discussed?
• • •
Recommendation for M/sS deformities-surgery
Pt wants to Proceed with Surgery?
Return appointment

Bunion Initial Work Medical Form

Podiatrist

There are 7 copies in use.
Published: May 18, 2015, 12:23 p.m.
Doctor: Dr. History Physical
Rating: 0   /

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