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CONDITION/DISORDER SYNONYMS

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  • Crohn disease

  • Ulcerative colitis (UC)

  • Regional enteritis

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ICD-9-CM CODES

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  • 555 Regional enteritis

  • 555.0 Regional enteritis of small intestine

  • 555.1 Regional enteritis of large intestine

  • 555.2 Regional enteritis of small intestine with large intestine

  • 555.9 Regional enteritis of unspecified site

  • Associated physical therapy diagnoses

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

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ICD-10-CM CODES

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  • K50.00 Crohn disease of small intestine without complications

  • K50.10 Crohn disease of large intestine without complications

  • K50.80 Crohn disease of both small and large intestine without complications

  • K50.90 Crohn disease, unspecified, without complications

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PREFERRED PRACTICE PATTERN

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  • As of July, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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FIGURE 41-1

Erythema nodosum: typical erythematous, tender nodules involving the pretibial region. (From McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. Principles and Practice of Hospital Medicine. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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PATIENT PRESENTATION

The patient is a 19-year-old female who presents to the clinic with antalgic gait and deconditioning. She presents as very thin and petite. She reports all her family is much taller but her growth has been limited by the inflammatory bowel disease (IBD). The patient states she has moderate pain in her low back, hips, and knees during walking. She reports abdominal cramping pain and it is exacerbated by her diet that is limited to nonfibrous foods. In addition, she frequently has upper respiratory colds due to the immune suppressant medication she takes for her IBD.

Upon physical therapy examination, the patient’s mobility status is modified independent because of pain during gait. Strength testing is 4/5 for bilateral upper extremities and lower extremities. Palpation of the thoracolumbar musculature does not reproduce pain. Active and passive movements of trunk rotation, side bending, and forward flexion mildly increase her low back pain and result in increased abdominal discomfort. She has full range of motion in her hips and knees but they are also mildlypainful throughout the entire range. The patient is observed to have a healed vertical incision just below her umbilicus resulting from a previous abdominal surgery. Patient reports she required a small bowel resection 5 years ago resulting from her IBD. Special tests such as palpation of McBurney point and the Pinch-an-inch test are positive for increased abdominal tenderness and you feel some firmness proximal to the ...

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