[Diagnostic Reasoning of Orthopedic Surgeons and Neurologists: Identifying Anatomical Structures and Mapping Neural...

Orthopedic surgeons and neurologists manage many of the same clinical manifestations, including sensory disturbances and muscle weakness in the upper and lower limbs, and gait impairment, and both emphasize anatomical diagnosis. However, their respective diagnostic processes differ. Orthopedic surgeons identify the responsible anatomical structures and interpret symptoms based on physical examination maneuvers and imaging findings. In contrast, neurologists map neurological findings onto neural pathways, proceeding from localization of the lesion to characterization of the clinical pattern and underlying etiology. In this article, the similarities and differences between the diagnostic reasoning processes used in these two specialties are reviewed, the clinical situations in which their diagnoses may diverge are discussed, and key considerations for mutual referral are outlined. Ongoing efforts to quantify assessment of muscle strength, as a common clinical language in orthopedic surgery and neurology, are described.