6 Key ChiroUp Condition Reference Updates to Enhance Your Success
The Condition Reference is the backbone of ChiroUp, providing up-to-date, evidence-based insights for over 150 conditions. This powerful resource fuels ChiroUp’s core functionalities, ensuring that your clinical decisions are backed by the latest research. In our latest update, we've enhanced the condition reference to improve your clinical outcomes and practice efficiency.
This blog covers the top six requested updates—each addressing critical business and clinical needs. At ChiroUp, we value your feedback and are committed to delivering a product that adapts to your evolving needs, so let’s dive in!
1. Typically Positive Tests
Evidence-based chiropractors use orthopedic testing to identify injured tissue. Sometimes, there is one test that is pathognomonic with a diagnosis. Other times, it takes several high-sensitivity and specificity tests to point to a specific tissue injury. For example, when applied correctly, the Ottawa Ankle Rules boast nearly 100% sensitivity in detecting fractures, effectively minimizing the risk of missed diagnoses. By adhering to these guidelines, practitioners can confidently rule out fractures in patients who do not meet the criteria, assuring clinicians and patients alike.
Moreover, these rules underscore the importance of not over-relying on imaging in every case but using it judiciously based on clinical suspicion and red flags. This balanced approach ensures that patients receive appropriate care without subjecting them to unnecessary procedures, aligning with evidence-based practice and enhancing diagnostic accuracy in ankle injuries.
Traditionally, ChiroUp shows you all the tests (orthopedic, neurologic, ROM, pathologic) that a chiropractor should perform per diagnosis. However, we have gone one step further and created a typically positive test section that will show you that when these tests are positive, you likely have the right diagnosis per that condition reference.
2. Typically Negative Tests
An essential aspect of accurately diagnosing musculoskeletal pain involves ruling out alternate sources of pathology. For example, cervical radiculopathy often mimics rotator cuff pathology as the cause of pain radiating to the upper arm. Astute practitioners balance positive and negative orthopedic tests to arrive at a reasonable differential diagnosis. The ChiroUp condition reference NOW offers valuable tests to help distinguish between regional pain syndromes in the Objective section.
For example, shoulder pain originating from the rotator cuff versus cervical radiculopathy. Given that cervical radiculopathy is prevalent and can present with symptoms closely resembling rotator cuff injuries, evaluating the cervical spine is crucial. The picture above is the Condition Reference from the Rotator Cuff Tendinopathy protocol. It shows that the Maximal Foraminal Compression and Modified Slump test will rule out potential pathology from the IVF, resulting in radiculopathy. Rent Sign and SLAP Provocation Cluster will rule out common causes of shoulder pain not attributed to rotator cuff tendinopathy. By incorporating negative orthopedic tests to rule out alternate etiologies, chiropractors can more accurately diagnose and manage shoulder conditions, ensuring effective and targeted treatment.
It is crucial to thoroughly evaluate the cervical spine as a potential source of shoulder pain due to the high prevalence of cervical radiculopathy presenting with arm pain (99%), sensory changes (85%), and neck pain (80%). Cervical radiculopathy affecting the C5-C6 nerve roots commonly causes pain radiating to the upper trapezius, deltoid, and lateral arm areas, innervated by nerves crucial for shoulder function. (1)
3. Related Muscles
Examining all the soft tissues involved in a specific diagnosis is helpful. Muscles often become hypertonic and painful after an injury due to protective mechanisms. After carefully reviewing the best available literature, we have listed the potential muscles associated with each diagnosis that are available for treatment. Videos on how to treat the muscles are available in the Plan section of the condition reference, as shown below.
Demonstrations include dry needling, contract-relax stretching, instrument-assisted soft tissue manipulation, and other research-backed techniques.
4. Condition-Specific Care Plans
It is unreasonable to suspect all tissue will heal at the same rate. For example, facia may take between 3-8 weeks to heal, while grade 1 strains of muscles should heal within a couple of weeks. Conversely, depending on the severity, tendon injuries may take up to a year to heal. Chiropractors must reflect these variations in tissue healing within their treatment plans. Treatment of muscle-related diagnoses like suboccipital headaches should take considerably less time to resolve than chronic tendinopathy of the rotator cuff. Specificity in diagnosis using orthopedic testing may help you accurately reflect each patient's prognosis.
Now, in the Assessment section of the condition reference, you can customize the care plan to the specific diagnosis, allowing you to shorten plans for fast-healing tissue and lengthen plans for more extended care.
Personal Opinion
I like to keep my initial trial of care the same for all patients: three times a week for two weeks. Depending on the initial diagnosis, some patients may be 25% better, while others may be 100% better. This strategy allows me to be consistent in tissue-specific diagnosis while keeping it standardized for scheduling and billing purposes.
5. Disability Index
Those who use the chief complaint survey functionality will now have visibility into the disability index provided after completing the survey. It is important to note a couple of things.
Automated disability surveys are limited to the Oswestry Disability Index (ODI), Neck Disability Survey (NDI), Lower Extremity Functional Score (LEFS), and Disability of the Arm Shoulder and Hand (DASH).
Disability surveys are sent automatically after the chief complaint survey (for subscribers who have that functionality enabled in their patient preferences).
If contiguous segments on the body selector connect to the spine—the appropriate low back or neck disability index is given due to the suspected radicular nature of symptoms.
6. ICD Codes
Billing and coding in a chiropractic office is like playing hide-and-seek with a mirror—you're not really sure if you’re winning or just confusing yourself. Fortunately, each condition in ChiroUp includes the associated reference codes needed to accurately document specific diagnoses. These can now be found within the Assessment section of the condition reference.
With these exciting updates to the condition reference, we’ve made it easier than ever to enhance your diagnostic accuracy, treatment planning, and patient outcomes. By incorporating your top-requested features, ChiroUp continues to evolve, providing you with the tools needed to streamline your practice. Log in now to check out the latest updates and see how these enhancements can support your clinical success!
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Karaman CA, Oz B, Sari A. Investigation of C5-C6 radiculopathy and shoulder rotator cuff lesions coexistence frequency. North Clin Istanb. 2018 Nov 16;6(3):260-266. doi: 10.14744/nci.2018.04796. PMID: 31650113; PMCID: PMC6790919.
