No. (%) of practice
patients consulting
Back
Knee
Neck
Foot
Shoulder
Hand
Hip
Total no. of
consultations in 1 year No. of consultations as % of all
musculoskeletal consultations
1100
470
360
330
370
210
210 20%
10%
6%
6%
7%
4%
4%
610 (6%)
340 (3%)
240 (2%)
220 (2%)
210 (2%)
140 (1%)
120 (1%)
Table – Consultations in 1 year for selected regions in a practice of 10,000
• Back problems were most common, 610 patients (6% of the practice population)
consulting for a back problem during the year
• 340 (3%) people consulted for knee problems, the 2 nd most common region
• The most common upper limb problems affected the shoulder (210 (2%) people
consulting)
• In children, the foot was the most common region for consultation,
accounting for 1 in 7 of all musculoskeletal consultations in this age group
300
275
250
PROBLEMS
An alternative approach to grouping by diagnosis is to classify patients according to the
GP record of location (‘region’) of the problem presented, for example, back or knee.
• 86% of musculoskeletal consultations were recorded as being for a single region (e.g.
back, knee)
• 8% of musculoskeletal consultations were recorded as being for multiple regions
• 6% of musculoskeletal consultations had no region specified
225
age 0-14
age 15-49
age 50+
200
175
150
125
100
75
50
25
0
Back
Knee
Neck
Foot
Shoulder
Hand
Hip
Figure 2 – Number of people consulting for problems in selected regions by age in practice of 10,000
DISCUSSION POINT
In older patients knee and hip problems are most commonly due to osteoarthritis (OA).
However, only a third of patients aged 50+ consulting for knee or hip problems had a
recorded diagnosis of OA.
It may be the problem was due to another disease. However, musculoskeletal problems
may be more often recorded using a regional code than a diagnosis label. GPs are asked
to choose a label (code) which best represents the reason for the consultation and often
code the presenting symptom (hip or knee pain) rather than the underlying disease
(OA). A symptom code may be selected because diagnoses often cannot be made with
certainty or because it is the symptom which is the focus of the consultation.
For more information visit:
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