Episode 10 – Quantifying Edema

A patient post Colles’ fracture has moderate edema in their fingers and the dorsum of their hand and reports pain during active range of motion. Which of the following measurements is the MOST appropriate to accurately quantify the patient’s edema? 

1. Volumetric
2. Circumferential
3. Girth
4. Anthropometric

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

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A patient post Colles’ fracture has moderate edema in their fingers and the dorsum of their hand and reports pain during active range of motion. Which of the following measurements is the MOST appropriate to accurately quantify the patient’s edema? 

1. Volumetric
2. Circumferential
3. Girth
4. Anthropometric

Colles’ Fracture
A Colles’ fracture is a fracture of the distal radius with dorsal displacement of the fractured segment. The most common mechanism of injury is a fall on an outstretched hand.

Volumetric measurements are often used to quantify the presence of edema in the wrist and hand by examining the amount of water displaced following immersion. It’s anticipated that a patient would have edema in the wrist and hand following this type of injury. 

Let’s explore each of the options:

Option 1 - Volumetric
A patient with moderate edema in the fingers and dorsum of the hand would displace more water than the contralateral extremity due to the involved limb’s increased volume. Although the contralateral extremity serves as an effective baseline measure, it’s important to recognize that there may normally be a small difference between the dominant and non-dominant hand.

Option 2 - Circumferential
Circumferential measurements using a flexible tape measure are most commonly used to obtain a gross estimate of edema or muscle atrophy.
When I think about circumferential measurements, I immediately think of larger areas of the body such as the thigh.

Circumferential measurements can be used on the hand, but it can be challenging to obtain accurate measurements because of the relative nonuniformity of the affected area.

Option 3 - Girth
There are a number of basic test taking strategies that can assist students to eliminate various options for non-academic reasons. For example, in this question, perhaps a student felt that option 2 circumferential measurements was a desirable method to quantify the patient’s edema.

Upon reading Option 3 - girth measurements, the student may have then become perplexed since girth measurements are synonymous with circumferential measurements. 

Because of this fact, the student should comfortably eliminate both options since it’s impossible for one of the two options to be correct and the other to be incorrect. 

Applying deductive reasoning strategies can be a useful tool to simplify the decision making process. 

Option 4 - Anthropometric
Common anthropometric measurements used for adults include height, weight, body mass index (BMI), waist-to-hip ratio, and percentage of body fat. These measures are then compared to reference standards to assess items such as weight status and the risk for various diseases.

This form of testing would not be effective to quantify the patient’s edema.

The correct answer is Option 1

Let’s explore the all student data:
57% of students selected Option 1, volumetric, the correct response
27% of students selected Option 2, circumferential
13% of students selected Option 3, girth
3% of students selected Option 4, anthropometric

System Classification
This question is an Other Systems question which represents approximately 21% of all exam items.

Content Outline Classification
This question is a Physical Therapy Examination question which represents approximately 24% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!

Watch the video version of this Q&A episode on YouTube -https://youtu.be/9M8eZyivMVs