Michael D. Ross, PT, DHSc: Essentials of Medical Screening and Differential Diagnosis in Physical Therapy Practice

Ross, Michael 09 003
Michael D. Ross, PT, DHSc

Essentials of Medical Screening and Differential Diagnosis in Physical Therapy Practice

March 16th-17th, 2018  (see schedule below)

Location: Bridgeside Point 1

 100 Technology Drive

Pittsburgh, PA 15213

1st Floor Classroom

Price: $275

All proceeds from this course will be donated to the Foundation for Physical Therapy as part of the Mercer-Marquette Challenge.


Attention CRS employees ONLY: If you have already submitted a CEPD, your registration is complete! No need to click the payment link below!



Sorry, but we are unable to issue refunds

Course Description


Physical therapists are now commonly looked upon as the provider of choice for musculoskeletal care. Screening for conditions not amenable to treatment by a physical therapist, or that require consultation/referral to other providers is a key skill. Therefore, physical therapists in today’s practice settings should have a clear understanding of how to appropriately screen for underlying medical conditions that can present as musculoskeletal conditions so that appropriate medical evaluation and management can be initiated as necessary.  Equally important is knowing what one can omit from the examination scheme on a given day, while placing the client at minimal risk. This course will explore the physical therapist’s role as an interdependent practitioner working within a collaborative medical model.  A proposed examination scheme will provide the structure for the course.  A main focus of the course will also be on presenting the clinical tools and decision-making processes necessary to efficiently and effectively collect and evaluate the history and physical examination data.  Professional communication with the patient/client and other health care professionals will also be a central theme.  Patient cases will be presented throughout the course as a means of applying differential diagnostic principles and promoting clinical decision-making.   This course will focus on clinical decision making principles in an outpatient, direct access physical therapy setting.  However, the principles presented will be applicable to any clinical setting.

Learning Objectives

  1. Describe the physical therapist’s role and responsibilities associated with the medical screening process.
  2. Examine patients using an advanced hypothetico-deductive reasoning model to facilitate diagnosis.
  3. Develop consistent clinical processes to assist in screening for systemic disease and other nonmusculoskeletal problems using health screening forms and an appropriately tailored systems review.
  4. Appropriately determine the patient/client who requires medical care not within the scope of physical therapist practice.
  5. Recognize the signs, symptoms, and rehabilitation implications of a broad spectrum of nonmusculoskeletal disorders.
  6. Function as a direct access practitioner.
  7. Serve as a mentor for peers on diagnosis and medical screening according to the principles of evidence-based practice.
  8. Engage in the diagnostic process to establish differential diagnosis across systems and across the lifespan.
  9. Formulate an enhanced working vocabulary of medical and differential diagnosis terminology.
  10. Employ strategies to facilitate professional communication between therapist and physician and therapist and patient/client, including when, how, and what to communicate regarding medical screening issues.

Continuing Education Units

This course is approved in: PA and NY
 Physical Therapists
Direct Access CEUs : 10 credits

Course Schedule

  DAY ONE: 16 March 2018 (3 hours)
Time Topic
5:00 – 6:30 Differential diagnosis and direct access practice in PT
6:30 – 6:45 Break
6:45 – 8:15 Introduction to review of systems and general health screening


  DAY TWO: 17 March 2018 (7 hours)
Time Topic
8:00 – 10:15 Cardiopulmonary, gastrointestinal, and urogenital screening
10:15 – 10:30 Break
10:30 – 12:00 Psychosocial and fear avoidance screening
12:00 – 1:00 Lunch
1:00 – 2:30 Upper quarter screening lab
2:30 – 2:45 Break
2:45 – 4:30 Abdominal palpation lab


About the Speaker

Michael D. Ross, PT, DHSc is an Assistant Professor in the Department of Physical Therapy at Daemen College in Amherst NY and a board-certified Orthopedic Clinical Specialist from the American Board of Physical Therapy Specialties.  Prior to his appointment at Daemen College, Dr. Ross served in the U.S. Air Force for 20 years where he was credentialed as a direct access provider with diagnostic imaging, medical laboratory, specialty physician referral, and pharmacological privileges.  He completed his Bachelor’s of Science in Physical Therapy from Daemen College, his Doctorate of Health Science in Physical Therapy from the University of Indianapolis, and a Fellowship in Orthopedic Manual Therapy and Musculoskeletal Primary Care from Kaiser Permanente Medical Center in Vallejo, CA.  He has made numerous scientific presentations and has lectured extensively at the entry-level, graduate, and postgraduate levels on medical screening and differential diagnosis in physical therapist practice.  Dr. Ross maintains an active community-based practice focusing on patients with chronic pain disorders and has published over 160 manuscripts and abstracts related to orthopedic physical therapist practice.  He served as the Editor for the Musculoskeletal Imaging feature of the Journal of Orthopaedic and Sports Physical Therapy from 2008 to 2016 and is a manuscript reviewer for several medical and rehabilitation journals.



  • Arroll B, Goodyear-Smith F, Kerse N, Fishman T, Gunn J. Effect of the addition of a “help” question to two screening questions on specificity for diagnosis of depression in general practice: diagnostic validity study. BMJ.  2005;331:884-888.
  • Baxter RE, Moore JH. Diagnosis and treatment of acute exertional rhabdomyolysis. J Orthop Sports Phys Ther. 2003;33:104-8.
  • Beneciuk JM, Bishop MD, Fritz JM, Robinson ME, Asal NR, Nisenzon AN, George SZ. The STarT back screening tool and individual psychological measures: evaluation of prognostic capabilities for low back pain clinical outcomes in outpatient physical therapy settings.  Phys Ther. 2013;93:321-33.
  • Boissonnault WG, Badke MB. Collecting health history information: the accuracy of a patient self-administered questionnaire in an orthopedic outpatient setting.  Phys Ther.  2005;85:531-43.
  • Boissonnault W, Goodman C. Physical therapists as diagnosticians: drawing the line on diagnosing pathology.  J Orthop Sports Phys Ther.  2006;36:351-353.
  • Boissonnault WG, Lovely K. Hospital-based outpatient direct access to physical therapist services: current status in Wisconsin.  Phys Ther. 2016;96:1695-1704.
  • Boissonnault WG, Ross MD. Physical therapists referring patients to physicians: a review of case reports and series.  J Orthop Sports Phys Ther. 2012;42:446-454.
  • Calley DQ, Jackson S, Collins H, George SZ. Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain.  J Orthop Sports Phys Ther. 2010;40:774-783.
  • Davenport TE, Kulig K, Resnik C. Diagnosing pathology to decide the appropriateness of physical therapy: what’s our role?  J Orthop Sports Phys Ther. 2006;36:1-2.
  • Day S, Fox J, Majercik S, Redmond FK, Pugh M, Bledsoe J. Implementing a domestic violence screening program.  J Trauma Nurs. 2015;22:176-81.
  • George SZ, Beneciuk JM, Lentz TA, Wu SS. The optimal screening for prediction of referral and outcome (OSPRO) in patients with musculoskeletal pain conditions: a longitudinal validation cohort from the USA.  BMJ Open. 2017;7:e015188.
  • Gray JC. Diagnosis of intermittent vascular claudication in a patient with a diagnosis of sciatica. Phys Ther. 1999;79:582-590.
  • Henschke N, Maher CG, Refshauge KM, et al. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain.  Arthritis Rheum  2009;60:3072-3080.
  • Holdsworth L, Webster VS, McFadyen AK. Physiotherapists’ and general practitioners’ views of self-referral and physiotherapy scope of practice: results from a national trial.  2008;94:236-243.
  • Jibuike OO, Paul-Taylor G, Maulvi S, et al. Management of soft tissue knee injuries in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner. Emerg Med J. 2003;20:37-39.
  • Kersten P, McPherson K, Lattimer V, et al. Systematic Review: Physiotherapy extended scope of practice – who is doing what and why? Physiotherapy. 2007. 93:235-242.
  • Leerar P, Boissonnault WG, Domholdt E, Roddey T. Documentation of red flags by physical therapists for patients with low back pain.  The Journal of Manual and Manipulative Therapy.  2007;15:42-49.
  • Mabry LM, Ross MD, Tonarelli JM. Metastatic cancer mimicking mechanical low back pain: a case report. J Man Manip Ther. 2014;22:162-9.
  • Madson TJ. Considerations in physical therapy management of a non-responding patient with low back pain.  Physiother Theory Pract. 2017;20:1-8.
  • McClellan CM, Greenwood R, Benger JR. Effect of an extended scope physiotherapy service on patient satisfaction and the outcome of soft tissue injuries in an adult emergency department. Emerg Med J; 2006;23:384-387.
  • McDermott MM, Ades P, Guralnik JM, et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial.  2009;301:165-74.
  • Mechelli F, Preboski Z, Boissonnault WG. Differential diagnosis of a patient referred to physical therapy with low back pain: abdominal aortic aneurysm.  J Orthop Sports Phys Ther. 2008;38:551-557.
  • Murphy DR, Morris NJ. Transitional cell carcinoma of the urethra [correction of ureter] in a patient with buttock pain: a case report.  Arch Phys Med Rehabil. 2008 Jan;89(1):150-152.
  • O’Laughlin SJ, Kokosinski E. Cauda equina syndrome in a pregnant woman referred to physical therapy for low back pain. J Orthop Sports Phys Ther. 2008;38:721.
  • Panju AA, Hemmelgarn BR, Guyatt GH, Simel DL. The rational clinical exam: Is this patient having a myocardial infarction?    1998;280:1256-1263.
  • Riddle DL, Hillner BE, Wells PS, Johnson RE, Hoffman HJ, Zuelzer WA. Diagnosis of lower-extremity deep vein thrombosis in outpatients with musculoskeletal disorders: a national survey study of physical therapists. Phys Ther. 2004;84:717-728.
  • Rohde RS, Kang JD. Thoracic disc herniation presenting with chronic nausea and abdominal pain. A case report. J Bone Joint Surg Am. 2004;86-A:379-81.
  • Scherer SA, Noteboom JT, Flynn TW. Cardiovascular assessment in the orthopaedic practice setting.  J Orthop Sports Phys Ther. 2005;35:730-7.
  • Sizer PS, Brismee JM, Cook C. Medical screening for red flags in the diagnosis and management of musculoskeletal spine pain. Pain Pract. 2007;7:53-71.
  • Sparkes V, Prevost AT, Hunter JO. Derivation and identification of questions that act as predictors of abdominal pain of musculoskeletal origin.  Eur J Gastroenterol  2003, 15:1021–1027.
  • Stowell T, Cioffredi W, Greiner A, Cleland J. Abdominal differential diagnosis in a patient referred to a physical therapy clinic for low back pain. J Orthop Sports Phys Ther. 2005;35:755-764.
  • Taylor NF, Norman E, Roddy L, et al. Primary contact physiotherapy n emergency departments can reduce length of stay for patients with peripheral musculoskeletal injuries compared with secondary contact physiotherapy: a prospective non-randomised controlled trial. Physiotherapy 2011 (97):107-114.
  • Troyer MR. Differential diagnosis of endometriosis in a young adult woman with nonspecific low back pain. Phys Ther. 2007;87:801-810.
  • Underwood M. Diagnosing acute nonspecific low back pain: time to lower the red flags?  Arthritis Rheum  2009;60:2855-2857.
  • Xiong Y, Lachmann E, Marini S, Nagler W. Thoracic disk herniation presenting as abdominal and pelvic pain: a case report.  Arch Phys Med Rehabil. 2001;82:1142-1144.







September 14, 2017 |