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. 2014 Nov;22(4):199–205. doi: 10.1179/2042618614Y.0000000068

Appendix: Alternative diagnostic sub-classifications in the Mechanical Diagnosis and Therapy system comprising the ‘Other’ category.

Category Definitions Criteria - Essential (Common) Examples (where necessary)
Trauma/recovering trauma Recent trauma associated with onset of symptoms Recent trauma associated with onset of constant symptoms/recent trauma associated with onset of symptoms in previous 6 weeks now intermittent and improving
Red flags Fracture to bone History of significant traumaLoss of functionAll movement make worse
Malignant tumor (Age>55)(History of cancer)(Unexplained weight loss)Progressive, non-mechanical pain, not relieved by rest
Inflammatory Inflammatory arthropathy ConstantExcessive movements exacerbate symptoms RA, some stages of OA
Chronic pain syndrome Pain-generating mechanism influenced by psychosocial factors or neurophysiological changes Persistent widespread painAggravation with all activityDisproportionate pain response to mechanical stimuliInappropriate beliefs and attitudes about pain Regional pain syndromes
Post-surgery Presentation relates to recent surgery Recent surgery (Local post-surgery protocols may apply)
Mechanically inconclusive Unknown joint pathology Inconsistent response to loading strategies (Inconsistent pattern of obstruction to movement)
Peripheral nerve entrapment Peripheral nerve entrapment No spinal symptomsLocal paresthesia/anesthesia (local muscle weakness) Carpal tunnel syndrome, meralgia paraesthetica
Articular structurally compromised Soft tissue and/or bony changes compromising joint integrity Mechanical symptoms (ROM restricted, clunking, locking, catching)(Sensation of instability)Long history of symptoms or history of traumaIrreversible with conservative care Late stage OA, dislocation, labral tear, cruciate ligament rupture, irreducible meniscal tear
Soft tissue disease process A fibroblastic or degenerative disease process affecting inert soft tissue with unknown or disputed etiology Each disease process has a unique clinical presentation, natural history, and varying degrees of efficacy to a variety of interventions Frozen shoulder, Dupuytren’s, plantar fascia syndrome
Vascular Symptoms induced by poor blood supply due to pressure increase in a closed anatomical space Poorly localized severe ache(Commonly induced by exercise or trauma)(Paresthesia in field of local cutaneous nerve)(Muscle feels tight or full) Compartment syndrome

Source: May S, Rosedale R. A survey of the McKenzie classification system in the extremities: prevalence of mechanical syndromes and preferred loading strategies. Phys. Ther. 2012 Jul 26 [Epub ahead of print].