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CONDITION/DISORDER SYNONYM

  • Diverticulosis

ICD-9-CM CODES

  • 562 Diverticula of intestine

  • 562.01 Diverticulitis of small intestine (without mention of hemorrhage)

  • 562.11 Diverticulitis of colon (without mention of hemorrhage)

  • Associated physical therapy diagnoses

    • 718.45 Contracture of joint, pelvic region and thigh

    • 781.2 Abnormality of gait

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 729.9 Other and unspecified disorders of soft tissue

    • 719.70 Difficulty in walking involving joint site unspecified

    • 782.3 Edema

    • 315.4 Developmental coordination disorder

    • 786.05 Shortness of breath

    • 780.7 Malaise and fatigue

    • 786.0 Dyspnea and respiratory abnormalities

ICD-10-CM CODES

  • K57.12 Diverticulitis of small intestine without perforation or abscess without bleeding

  • K57.32 Diverticulitis of large intestine without perforation or abscess without bleeding

PREFERRED PRACTICE PATTERN

  • As of June, 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.

PATIENT PRESENTATION

Patient is a 46-year-old female who presents to your clinic with dull left lower back and pelvic pain. She denies any movements that make the pain worse or better. The patient also reports a crampy lower abdominal pain that increases after eating. Further interview of the patient reveals she frequents the restroom with urgency and that her stools are dark. In addition, the patient states that she has trouble getting through her day as she has felt more fatigued recently.

Patient is a direct access, self-pay, without a physician’s referral. During the initial physical therapy examination, palpation of the thoraco-lumbar musculature does not reveal pain. Active and passive movements at trunk rotation, side bending, and forward flexion do not increase low back pain but result in increased abdominal discomfort. Hip flexion also does not reveal increased pelvic discomfort. Special tests such as palpation of McBurney point and the Pinch-an-inch test are positive for increased abdominal tenderness. Palpation of the left iliopsoas muscle and resisted left hip flexion does not increase low back pain; however, the tests do reproduce abdominal tenderness.

FIGURE 37-1

CT of abdomen in a 60-year-old female presenting with left lower quadrant abdominal pain showing sigmoid colon mural thickening, several colonic diverticula, and associated mesocolic fat infiltration, findings consistent with acute diverticulitis. (From McKean S, 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.)

KEY FEATURES

Description

  • Focal inflammation of the diverticula (sacs) in any part of the digestive tract but most commonly in the large intestine1

  • Secondary problems such as weakness, gait abnormalities, and limited aerobic endurance

  • May be acute, postoperative, ...

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