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].