You are assessing a 91 year old man who recently fractured his hip in a fall. Which one of the following components of examination is most likely to influence your immediate management of his falls risk?
ExplanationBenign positional vertigo is common and amenable to treatment with simple positional manoeuvres. Supine blood pressure alone will tell you little; postural blood pressure is more important. Finding a reduced hip extension range would be unsurprising after recent hip surgery. Whilst depression is important, finding it will not directly influence your plans for reducing his falls risk. Cardiac auscultation may uncover a murmur of aortic stenosis – a cause of syncopal episodes potentially amenable to intervention – but this is less likely than option C, and even if you find severe aortic stenosis, comorbid disease and frailty might prevent you from intervening successfully.