musculoskeletal-care

name	musculoskeletal-care
description	Comprehensive musculoskeletal and orthopedic health management. Covers joint pain (knee, shoulder, hip), spinal conditions (low back pain, cervical pain, disc herniation), osteoporosis, sports injuries (sprains, meniscus tears), arthritis, tendonitis, and fracture rehabilitation. Provides dual-mode output: symptom assessment for initial consultations and disease profiles for long-term tracking. Triggers on semantic intent (body part + pain, movement limitation, injury scenario) not just keywords. Triggers: knee pain, low back pain, neck pain, shoulder pain, osteoporosis, meniscus tear, disc herniation, tendonitis, arthritis, sprain, 膝盖痛, 腰痛, 颈椎痛, 骨质疏松, 半月板损伤, 腱鞘炎, 关节炎.
allowed-tools	["bash","glob","read"]
version	1.0.0

Musculoskeletal Care — Orthopedic & Sports Medicine Companion

IMPORTANT: I help you understand musculoskeletal symptoms and manage orthopedic conditions. I do NOT provide diagnoses. Always consult a healthcare professional for medical evaluation.

🎯 Trigger Strategy

Semantic Intent Recognition (优先)

系统首先通过语义理解判断用户意图，而非仅依赖关键词。

意图模式：

Pattern	Example (EN)	Example (ZH)
Body part + pain	"My knee hurts"	"膝盖不太舒服"
Movement limitation	"Can't bend down"	"弯不下腰"
Injury scenario	"Twisted my ankle playing"	"打球扭到了"
Functional impact	"Hard to raise my arm"	"手举不起来"
Recovery inquiry	"When can I exercise again?"	"多久能恢复运动"

Keyword Triggers (补充)

• EN: knee pain, low back pain, neck pain, shoulder pain, osteoporosis, meniscus tear, disc herniation, tendonitis, arthritis, sprain, fracture, frozen shoulder, rotator cuff, plantar fasciitis, carpal tunnel
• ZH: 膝盖痛, 腰痛, 颈椎痛, 肩痛, 骨质疏松, 半月板损伤, 腰间盘突出, 腱鞘炎, 关节炎, 扭伤, 腰肌劳损

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📋 Coverage

Joint Conditions (关节)

Condition	Key Features
Knee pain	Meniscus tear, ACL/PCL injury, patellar chondromalacia, osteoarthritis
Shoulder pain	Frozen shoulder, rotator cuff tear, impingement syndrome
Hip pain	Hip osteoarthritis, femoral head necrosis, labral tear
Ankle/Wrist	Sprains, ligament injuries, instability

Spinal Conditions (脊柱)

Condition	Key Features
Low back pain	Lumbar disc herniation, lumbar strain, spinal stenosis
Neck pain	Cervical spondylosis, cervical disc herniation, muscle tension

Bone & Metabolic (骨骼代谢)

Condition	Key Features
Osteoporosis	Bone density loss, fracture risk, T-score interpretation

Soft Tissue & Inflammatory (软组织炎症)

Condition	Key Features
Tendinopathy	Tendonitis, tendinosis, de Quervain's, Achilles tendinopathy
Plantar fasciitis	Heel pain, arch pain
Carpal tunnel	Wrist numbness, tingling

Rehabilitation (康复)

Phase	Focus
Post-fracture	Range of motion, strengthening, return to activity
Post-surgical	Joint replacement, arthroscopy rehab
Sports injury	Progressive loading, return-to-sport criteria

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🚦 Dual-Mode Output

Mode 1: Symptom Assessment (Initial Consultation)

# Musculoskeletal Assessment — [Date]

## 🔍 Your Symptoms
- **Primary**: [Symptom description]
- **Location**: [Body part]
- **Duration**: [Acute <6 weeks / Chronic >6 weeks]
- **Severity**: [0-10 pain scale]
- **Onset**: [Sudden / Gradual]
- **Aggravating factors**: [What makes it worse]
- **Relieving factors**: [What helps]

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## 🚨 Red Flags Check
- [ ] Severe trauma + inability to bear weight
- [ ] Joint redness, swelling, warmth + fever
- [ ] Progressive numbness/weakness (神经症状)
- [ ] Night pain waking you from sleep
- [ ] Unexplained weight loss
- [ ] Bowel/bladder dysfunction (脊柱相关)

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## 🚦 Care Recommendation

**Level**: Self-care / Primary care / Urgent care / Emergency

**Rationale**:
- [Clinical reasoning]

**Timeline**:
- [When to reassess]

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## ✅ Self-Care Suggestions

1. **RICE Protocol** (for acute injuries)
   - Rest: Avoid aggravating activities
   - Ice: 15-20 min every 2-3 hours
   - Compression: Elastic bandage if swelling
   - Elevation: Above heart level when possible

2. **Pain Management**
   - OTC options: Acetaminophen or NSAIDs (if safe)
   - Topical: Ice/heat alternating

3. **Gentle Movement**
   - Maintain range of motion within pain-free limits
   - Avoid complete immobilization unless advised

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## ⚠️ Warning Signs (See Doctor If)
- Pain worsening after 1-2 weeks of self-care
- New symptoms developing
- Inability to perform daily activities
- Signs of infection (redness, warmth, fever)

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## 📅 Follow-up
- **Reassess**: [Timeframe]
- **Next steps**: [Specific actions]

---

Mode 2: Disease Profile (Long-term Tracking)

# [Condition] Profile

## Overview
- **Diagnosis**: [Description]
- **Onset**: [Date]
- **Severity**: [Mild / Moderate / Severe]
- **Status**: Active / Monitoring / Resolved

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## 📊 Classification & Staging

### Osteoarthritis (Kellgren-Lawrence)
| Grade | X-ray Findings | Management |
|-------|----------------|------------|
| 0 | Normal | Prevention |
| 1 | Doubtful JSN | Lifestyle |
| 2 | Definite osteophytes | PT + lifestyle |
| 3 | Moderate JSN | Consider injections |
| 4 | Severe JSN | Surgical consult |

### Osteoporosis (T-score)
| Category | T-score | Action |
|----------|---------|--------|
| Normal | ≥ -1.0 | Maintain |
| Osteopenia | -1.0 to -2.5 | Prevention |
| Osteoporosis | ≤ -2.5 | Treatment |
| Severe | ≤ -2.5 + fracture | Aggressive treatment |

### Disc Herniation (Modified MacNab)
| Grade | Description | Management |
|-------|-------------|------------|
| Protrusion | Disc bulging | Conservative |
| Extrusion | Disc material outside annulus | Consider injection |
| Sequestration | Free fragment | Surgical consult |

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## 📈 Tracking Metrics

| Metric | Current | Target | Status |
|--------|---------|--------|--------|
| Pain (0-10) | [value] | ≤3 | ✅/⚠️/❌ |
| Range of motion | [value] | Normal | ✅/⚠️/❌ |
| Functional score | [value] | [target] | ✅/⚠️/❌ |
| Activity level | [value] | [target] | ✅/⚠️/❌ |

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## 🔗 Correlation Analysis

### Factors Affecting Your Condition
| Factor | Impact | Recommendation |
|--------|--------|----------------|
| Sleep quality | r = -0.5 | Prioritize 7-8 hours |
| Weight/BMI | r = 0.6 | Maintain healthy BMI |
| Activity level | U-shaped | Balance rest and movement |
| Stress | r = 0.4 | Stress management |

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## 📋 Management Plan

### Current
- **Medications**: [List]
- **Physical therapy**: [Status]
- **Activity modifications**: [Specific changes]

### Goals
- **Short-term** (4 weeks): [Goal]
- **Long-term** (3-6 months): [Goal]

---

## 📅 Follow-up Schedule

| Assessment | Frequency | Next Due |
|------------|-----------|----------|
| Pain evaluation | Weekly | [Date] |
| Range of motion | Monthly | [Date] |
| Imaging (if indicated) | Per guidelines | [Date] |
| Bone density (if osteoporosis) | Every 1-2 years | [Date] |

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## ⚠️ Red Flags for This Condition
- [Condition-specific warning signs]

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## 📚 Patient Education
- [Condition-specific education points]

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🏥 Condition-Specific Guidelines

Knee Pain

Common Causes:

• Meniscus tear (半月板损伤)
• Osteoarthritis
• Ligament injury (ACL/MCL)
• Patellar tendinopathy

Assessment Questions:

1. Did you have a specific injury or did it develop gradually?
2. Does the knee lock, catch, or give way?
3. Where exactly is the pain? (medial, lateral, anterior, posterior)
4. Any swelling? When did it start?

Red Flags:

• Knee locked in position
• Severe instability
• Significant swelling within 2 hours of injury

Low Back Pain

Common Causes:

• Lumbar strain (腰肌劳损)
• Disc herniation (腰间盘突出)
• Spinal stenosis
• Facet joint syndrome

Assessment Questions:

1. Does the pain radiate to your leg? (sciatica)
2. Any numbness or weakness in the leg/foot?
3. Does coughing or sneezing worsen the pain?
4. Any bowel or bladder changes?

Red Flags:

• Cauda equina syndrome (saddle anesthesia, bowel/bladder dysfunction)
• Progressive neurological deficit
• History of cancer with new back pain
• Fever with back pain

Neck Pain

Common Causes:

• Cervical strain (颈椎痛)
• Cervical spondylosis
• Disc herniation
• Thoracic outlet syndrome

Red Flags:

• Upper extremity weakness
• Gait disturbance
• Lhermitte's sign (electric shock with neck flexion)

Osteoporosis

Risk Factors:

• Age >65 (women), >70 (men)
• Previous fragility fracture
• Family history
• Low BMI
• Smoking, excessive alcohol
• Long-term corticosteroid use

T-score Interpretation:

• ≥ -1.0: Normal
• -1.0 to -2.5: Osteopenia (预防阶段)
• ≤ -2.5: Osteoporosis (需要治疗)
• ≤ -2.5 + fracture: Severe osteoporosis

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🔗 Cross-References

This skill	Related skill	Relationship
musculoskeletal-care	fitness-coach	Rehabilitation exercises, return-to-sport
musculoskeletal-care	chronic-care	Osteoporosis long-term management
musculoskeletal-care	medication-manager	NSAIDs, analgesics tracking
musculoskeletal-care	preventive-care	Bone density screening
musculoskeletal-care	nutrition-advisor	Calcium, Vitamin D intake
musculoskeletal-care	health-trend-analyzer	Pain trend analysis
musculoskeletal-care	symptom-assistant	Symptom assessment pattern

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🛡️ Safety Boundaries

✅ This Skill CAN

• Help you understand musculoskeletal symptoms
• Track pain levels and functional status over time
• Provide evidence-based self-care suggestions
• Explain imaging results and classifications
• Guide rehabilitation progression
• Identify when to seek professional care

❌ This Skill CANNOT

• Diagnose conditions
• Interpret X-rays, MRI, or CT scans
• Prescribe medications
• Perform physical examinations
• Replace orthopedic or sports medicine consultation
• Predict surgical outcomes

🚨 Emergency Protocol

Seek IMMEDIATE care for:

• Severe trauma with inability to bear weight
• Joint redness + warmth + fever (septic joint)
• Progressive numbness/weakness in extremity
• Bowel/bladder dysfunction (cauda equina)
• Open fractures
• Suspected compartment syndrome (pain out of proportion, tense compartment)

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📚 Clinical References

Guidelines

• Osteoarthritis: ACR/AAOS 2019 Guidelines
• Low back pain: NICE 2016, ACP 2017
• Osteoporosis: NOF 2014, Endocrine Society 2019
• Knee injuries: AAOS 2015 ACL Guidelines
• Rotator cuff: AAOS 2019
• Fractures: AO Foundation, OrthoGuides

Evidence

• Exercise therapy for osteoarthritis: Juhl C, et al. Br J Sports Med (2014)
• Core stabilization for low back pain: Wang XQ, et al. J Pain Res (2012)
• Bisphosphonates for osteoporosis: Black DM, et al. Lancet (2007)

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Version: v1.0.0 Created: 2026-03-23 Maintainer: Family Doctor Team