from docx import Document
from docx.shared import Pt, Inches, RGBColor, Cm
from docx.enum.text import WD_ALIGN_PARAGRAPH
from docx.enum.table import WD_TABLE_ALIGNMENT, WD_ALIGN_VERTICAL
from docx.oxml.ns import qn
from docx.oxml import OxmlElement
import copy

doc = Document()

# ── Page margins ──────────────────────────────────────────────────────────────
for section in doc.sections:
    section.top_margin    = Cm(1.8)
    section.bottom_margin = Cm(1.8)
    section.left_margin   = Cm(2.0)
    section.right_margin  = Cm(2.0)

# ── Base styles ───────────────────────────────────────────────────────────────
normal = doc.styles["Normal"]
normal.font.name = "Arial"
normal.font.size = Pt(9)

# ── Color palette ─────────────────────────────────────────────────────────────
DARK_BLUE  = RGBColor(0x1A, 0x3A, 0x5C)   # header fill
MID_BLUE   = RGBColor(0x2E, 0x6D, 0xA4)   # section headings
LIGHT_BLUE = RGBColor(0xD6, 0xE8, 0xF7)   # table header row fill
REGION_COLORS = {
    "KNEE":     RGBColor(0x1F, 0x5C, 0x99),
    "SHOULDER": RGBColor(0x1A, 0x7A, 0x4A),
    "SPINE":    RGBColor(0x7A, 0x3A, 0x00),
    "HIP":      RGBColor(0x6A, 0x1A, 0x6A),
}
REGION_FILLS = {
    "KNEE":     "D0E4F5",
    "SHOULDER": "D0F0DC",
    "SPINE":    "F5E6CC",
    "HIP":      "F0D0F0",
}

# ── Helpers ───────────────────────────────────────────────────────────────────
def set_cell_bg(cell, hex_color):
    tc   = cell._tc
    tcPr = tc.get_or_add_tcPr()
    shd  = OxmlElement("w:shd")
    shd.set(qn("w:val"),   "clear")
    shd.set(qn("w:color"), "auto")
    shd.set(qn("w:fill"),  hex_color)
    tcPr.append(shd)

def set_cell_borders(cell, top="single", bottom="single", left="single", right="single", color="AAAAAA", sz="4"):
    tc   = cell._tc
    tcPr = tc.get_or_add_tcPr()
    tcBorders = OxmlElement("w:tcBorders")
    for side, val in [("top",top),("bottom",bottom),("left",left),("right",right)]:
        b = OxmlElement(f"w:{side}")
        b.set(qn("w:val"),   val)
        b.set(qn("w:sz"),    sz)
        b.set(qn("w:space"), "0")
        b.set(qn("w:color"), color)
        tcBorders.append(b)
    tcPr.append(tcBorders)

def no_space_before(para):
    pPr = para._p.get_or_add_pPr()
    spacing = OxmlElement("w:spacing")
    spacing.set(qn("w:before"), "0")
    spacing.set(qn("w:after"),  "40")
    pPr.append(spacing)

def add_cell_text(cell, text, bold=False, size=9, color=None, italic=False):
    para = cell.paragraphs[0]
    para.clear()
    run  = para.add_run(text)
    run.font.name  = "Arial"
    run.font.size  = Pt(size)
    run.font.bold  = bold
    run.font.italic = italic
    if color:
        run.font.color.rgb = color
    no_space_before(para)
    return para

def add_checkbox_row(table, label, hint="", shade=False):
    row   = table.add_row()
    cells = row.cells
    # checkbox cell
    add_cell_text(cells[0], "☐", bold=False, size=10)
    cells[0].width = Inches(0.25)
    # label cell
    p = add_cell_text(cells[1], label, bold=False, size=9)
    # hint cell
    add_cell_text(cells[2], hint, bold=False, size=8, italic=True, color=RGBColor(0x55,0x55,0x55))
    if shade:
        for c in cells:
            set_cell_bg(c, "F7F7F7")
    for c in cells:
        set_cell_borders(c)
    return row

def add_section_header(table, title, fill_hex="2E6DA4"):
    row   = table.add_row()
    cells = row.cells
    # merge all 3 columns
    cells[0].merge(cells[2])
    p = add_cell_text(cells[0], title, bold=True, size=9, color=RGBColor(0xFF,0xFF,0xFF))
    set_cell_bg(cells[0], fill_hex)
    set_cell_borders(cells[0], color="FFFFFF", sz="6")
    return row

def add_free_text_row(table, label, lines=1):
    row   = table.add_row()
    cells = row.cells
    cells[0].merge(cells[2])
    underline = "___________________________________________" * 2
    run_text  = f"{label}:  {underline[:50]}"
    add_cell_text(cells[0], run_text, bold=False, size=9)
    set_cell_borders(cells[0])
    return row

# ══════════════════════════════════════════════════════════════════════════════
# COVER / TITLE BLOCK
# ══════════════════════════════════════════════════════════════════════════════
# Title table (full-width dark blue header)
title_tbl = doc.add_table(rows=1, cols=1)
title_tbl.alignment = WD_TABLE_ALIGNMENT.CENTER
title_tbl.style = "Table Grid"
tc = title_tbl.rows[0].cells[0]
set_cell_bg(tc, "1A3A5C")
p = tc.paragraphs[0]
p.alignment = WD_ALIGN_PARAGRAPH.CENTER
run = p.add_run("ORTHOPAEDIC HISTORY-TAKING FORM")
run.font.name  = "Arial"
run.font.size  = Pt(16)
run.font.bold  = True
run.font.color.rgb = RGBColor(0xFF, 0xFF, 0xFF)
pPr = p._p.get_or_add_pPr()
sp = OxmlElement("w:spacing"); sp.set(qn("w:before"),"120"); sp.set(qn("w:after"),"120"); pPr.append(sp)

sub_tbl = doc.add_table(rows=1, cols=1)
sub_tbl.alignment = WD_TABLE_ALIGNMENT.CENTER
sub_tbl.style = "Table Grid"
tc2 = sub_tbl.rows[0].cells[0]
set_cell_bg(tc2, "D6E8F7")
p2 = tc2.paragraphs[0]
p2.alignment = WD_ALIGN_PARAGRAPH.CENTER
run2 = p2.add_run("Regions Covered: Knee  |  Shoulder  |  Spine  |  Hip      Ref: Miller's Review of Orthopaedics 9th Ed | Campbell's Operative Orthopaedics 15th Ed 2026")
run2.font.name   = "Arial"
run2.font.size   = Pt(8)
run2.font.italic = True
run2.font.color.rgb = DARK_BLUE

doc.add_paragraph()  # spacer

# ── Patient demographic strip ──────────────────────────────────────────────
demo_tbl = doc.add_table(rows=2, cols=6)
demo_tbl.style = "Table Grid"
demo_headers = ["Patient Name", "Age", "Sex", "Date", "Clinician", "MRN"]
for i, h in enumerate(demo_headers):
    set_cell_bg(demo_tbl.rows[0].cells[i], "2E6DA4")
    add_cell_text(demo_tbl.rows[0].cells[i], h, bold=True, size=8, color=RGBColor(0xFF,0xFF,0xFF))
    add_cell_text(demo_tbl.rows[1].cells[i], "", bold=False, size=9)
    set_cell_borders(demo_tbl.rows[1].cells[i])

doc.add_paragraph()

# ══════════════════════════════════════════════════════════════════════════════
# GENERIC SECTION  (applies to all regions)
# ══════════════════════════════════════════════════════════════════════════════
def make_generic_section(doc):
    h = doc.add_heading("A.  COMMON HISTORY  (Complete for ALL regions)", level=2)
    h.runs[0].font.color.rgb = DARK_BLUE
    h.runs[0].font.size = Pt(11)

    tbl = doc.add_table(rows=1, cols=3)
    tbl.style = "Table Grid"
    tbl.columns[0].width = Inches(0.28)
    tbl.columns[1].width = Inches(2.6)
    tbl.columns[2].width = Inches(3.4)

    # column headers
    hrow = tbl.rows[0]
    for c, txt in zip(hrow.cells, ["", "Item", "Clinical Significance / Hint"]):
        set_cell_bg(c, "1A3A5C")
        add_cell_text(c, txt, bold=True, size=8, color=RGBColor(0xFF,0xFF,0xFF))

    # Chief Complaint
    add_section_header(tbl, "1. CHIEF COMPLAINT", "2E6DA4")
    items = [
        ("Pain",                      "Most common; characterise with SOCRATES"),
        ("Swelling / effusion",       "Acute (<6 h = hemarthrosis) vs. chronic"),
        ("Stiffness",                 "Morning stiffness >1 h → inflammatory"),
        ("Limitation of motion",      "Active vs. passive restriction"),
        ("Weakness",                  "Nerve / tendon / muscle origin"),
        ("Instability / giving way",  "Ligamentous, patellar, neurological"),
        ("Deformity",                 "Progressive vs. fixed"),
        ("Functional loss",           "ADL, work, sport"),
    ]
    for i,(item,hint) in enumerate(items):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # SOCRATES Pain
    add_section_header(tbl, "2. PAIN CHARACTERISATION (SOCRATES)", "2E6DA4")
    pain_items = [
        ("Site",              "Exact location; point with one finger"),
        ("Onset",             "Sudden (trauma) vs. insidious (OA, overuse)"),
        ("Character",         "Sharp / dull / burning (neuropathic) / throbbing"),
        ("Radiation",         "Down leg (radiculopathy) / up arm / referred"),
        ("Associations",      "Locking, clicking, neurological symptoms"),
        ("Time course",       "Constant vs. intermittent; progressive vs. episodic"),
        ("Exacerbating",      "Weight-bearing, activity, position, Valsalva"),
        ("Relieving",         "Rest, NSAIDs, ice, elevation, specific posture"),
        ("Severity (VAS)",    "0 = none  →  10 = worst imaginable"),
    ]
    for i,(item,hint) in enumerate(pain_items):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # Mechanism
    add_section_header(tbl, "3. MECHANISM OF INJURY", "2E6DA4")
    mech = [
        ("Traumatic onset",               "Date, time, exact activity"),
        ("Contact vs. non-contact",        "Non-contact + pop → ACL / patellar disloc."),
        ("Direction of force",             "Valgus / varus / hyperextension / rotation"),
        ("Energy level",                   "High (MVA, collision) vs. low (ground fall)"),
        ("Audible / palpable 'pop'",       "ACL tear, tendon rupture"),
        ("Position of limb at injury",     "Foot position, arm position"),
        ("Acute swelling < 2 h",          "Haemarthrosis (ACL, fracture, meniscus)"),
        ("Delayed swelling > 24 h",       "Minor meniscal / synovial injury"),
        ("Insidious / overuse onset",      "Repetitive load, gradual progression"),
    ]
    for i,(item,hint) in enumerate(mech):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # PMH
    add_section_header(tbl, "4. PAST MEDICAL & SURGICAL HISTORY", "2E6DA4")
    pmh = [
        ("Previous injury to same region",   "Recurrence, pre-existing instability"),
        ("Previous surgeries",               "Hardware, soft-tissue repairs"),
        ("Osteoporosis / metabolic bone",    "Fragility fractures, bisphosphonate use"),
        ("Inflammatory arthritis (RA / AS)", "Systemic disease, DMARDs"),
        ("Diabetes mellitus",                "Infection risk, neuropathy, wound healing"),
        ("Cardiovascular / respiratory",     "Surgical / anaesthetic risk"),
        ("Malignancy (current / past)",      "Bone metastasis screen"),
        ("Coagulation disorder",             "Haemarthrosis, anticoagulation"),
    ]
    for i,(item,hint) in enumerate(pmh):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # Medications
    add_section_header(tbl, "5. MEDICATIONS & ALLERGIES", "2E6DA4")
    meds = [
        ("NSAIDs / analgesics",          "Current pain management"),
        ("Steroids (systemic / local)",  "Bone quality, AVN risk, wound healing"),
        ("Anticoagulants",               "Warfarin / DOAC — surgical timing"),
        ("DMARDs / biologics",           "Peri-op management, infection risk"),
        ("Bisphosphonates",              "Atypical femoral fracture risk"),
        ("Drug allergies",               "Latex, antibiotics, metal implants"),
    ]
    for i,(item,hint) in enumerate(meds):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # Social
    add_section_header(tbl, "6. SOCIAL HISTORY", "2E6DA4")
    social = [
        ("Occupation",           "Manual vs. sedentary; return-to-work goals"),
        ("Sporting activity",    "Level, specific sport, competitive vs. recreational"),
        ("Smoking",              "Impairs bone healing, fusion rates"),
        ("Alcohol use",          "AVN risk (hip); fall risk"),
        ("IV drug use",          "Osteomyelitis, septic arthritis risk"),
        ("Living situation",     "Stairs, independence — post-op planning"),
        ("Dominant side",        "Upper limb especially"),
        ("Walking aids used",    "Cane, crutch, frame"),
    ]
    for i,(item,hint) in enumerate(social):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    # Family
    add_section_header(tbl, "7. FAMILY HISTORY", "2E6DA4")
    fam = [
        ("Inflammatory arthritis",  "RA, AS, psoriatic"),
        ("Malignancy",              "Bone tumour, metastatic disease"),
        ("Connective tissue disorders", "Marfan, Ehlers-Danlos → instability"),
    ]
    for i,(item,hint) in enumerate(fam):
        add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    doc.add_paragraph()

make_generic_section(doc)

# ══════════════════════════════════════════════════════════════════════════════
# REGIONAL SECTIONS
# ══════════════════════════════════════════════════════════════════════════════

def make_region_table(doc, region_title, fill_hex, items_dict):
    """
    items_dict: ordered list of (section_title, [(item, hint), ...])
    """
    h = doc.add_heading(f"B{list(REGION_FILLS.keys()).index(region_title.split()[0].upper())+1}.  {region_title}", level=2)
    h.runs[0].font.color.rgb = RGBColor(int(fill_hex[0:2],16), int(fill_hex[2:4],16), int(fill_hex[4:6],16))
    h.runs[0].font.size = Pt(11)

    tbl = doc.add_table(rows=1, cols=3)
    tbl.style = "Table Grid"
    tbl.columns[0].width = Inches(0.28)
    tbl.columns[1].width = Inches(2.6)
    tbl.columns[2].width = Inches(3.4)

    hrow = tbl.rows[0]
    for c, txt in zip(hrow.cells, ["", "Region-specific Item", "Clinical Significance / Hint"]):
        set_cell_bg(c, fill_hex)
        add_cell_text(c, txt, bold=True, size=8, color=RGBColor(0xFF,0xFF,0xFF))

    for section_title, rows in items_dict:
        add_section_header(tbl, section_title, fill_hex)
        for i,(item,hint) in enumerate(rows):
            add_checkbox_row(tbl, item, hint, shade=(i%2==0))

    doc.add_paragraph()

# ─── KNEE ──────────────────────────────────────────────────────────────────
knee_data = [
    ("KNEE — SYMPTOM CHARACTERISATION", [
        ("Pain location",                        "Anterior=patellofem; medial=MCL/medial menisc; lateral=LCL/IT band; posterior=PCL/Baker's cyst"),
        ("Pain after sitting / stair climbing",  "Patellofemoral syndrome (theatre sign)"),
        ("Locking (true) — cannot extend",       "Meniscal bucket-handle tear; loose body"),
        ("Pseudo-locking — pain-limited",        "Hamstring spasm, patellofemoral"),
        ("Pain with squatting / deep flexion",   "Meniscal tear, patellofemoral"),
        ("Giving way",                           "ACL insufficiency, patellar instability"),
        ("Acute swelling < 2 h (haemarthrosis)", "ACL tear, osteochondral fracture, periph. meniscal tear"),
        ("Effusion > 24 h (synovial fluid)",     "Meniscal, synovitis, reactive"),
        ("Clicking / snapping",                  "Discoid meniscus, IT band syndrome, loose body"),
        ("Night pain at rest",                   "Infection, tumour — red flag"),
    ]),
    ("KNEE — MECHANISM OF INJURY (from Miller's Review of Orthopaedics)", [
        ("Non-contact + pop + acute swelling",       "ACL tear until proven otherwise"),
        ("Non-contact + pop (no major swelling)",    "Patellar dislocation"),
        ("Contact + pop — valgus force",             "MCL ± ACL ± medial meniscus (O'Donoghue triad)"),
        ("Contact + pop — varus force",              "LCL / posterolateral corner (PLC)"),
        ("Hyperextension + varus + tibial ext. rot", "PLC injury"),
        ("Anterior tibial force, foot plantar-flexed","PCL injury"),
        ("Dashboard / direct posterior tibia blow",  "PCL or patellar injury"),
        ("Anterior force, foot dorsiflexed",         "Patellar injury"),
        ("Twisting on planted foot",                 "Meniscal tear ± ACL"),
    ]),
    ("KNEE — FUNCTIONAL & ACTIVITY ASSESSMENT", [
        ("Walking distance before pain",             "OA / claudication screen"),
        ("Stairs (ascending vs. descending worse)",  "Descending worse → patellofemoral"),
        ("Sport / activity level (Tegner score)",    "Document pre-injury vs. current"),
        ("Use of brace or walking aid",              "Degree of functional compromise"),
        ("Previous episodes of same injury",         "Chronic instability, re-tear"),
    ]),
    ("KNEE — RED FLAGS", [
        ("Fever + hot swollen joint",                "EMERGENCY: septic arthritis"),
        ("Night pain not relieved by rest",          "Malignancy / infection"),
        ("History of malignancy",                    "Bone metastasis / primary bone tumour"),
        ("Rapid unexplained swelling",               "Haemarthrosis, fracture"),
        ("Neurovascular symptoms (numbness/cold)",   "Popliteal artery / nerve injury — urgent"),
    ]),
]
make_region_table(doc, "KNEE  –  Specific History Checklist", REGION_FILLS["KNEE"].replace("0x",""), knee_data)

# ─── SHOULDER ──────────────────────────────────────────────────────────────
shoulder_data = [
    ("SHOULDER — SYMPTOM CHARACTERISATION", [
        ("Age group",                                "Young: instability, AC injury; Older: rotator cuff, arthritis, fracture"),
        ("Pain location",                            "Anterior=instability; lateral deltoid=impingement/RC; posterior=posterior instability"),
        ("Pain with overhead activity",              "Rotator cuff impingement / tear"),
        ("Night pain (lying on affected side)",      "Strongly suggests rotator cuff tear"),
        ("Feeling of shoulder 'popping out'",        "Glenohumeral instability / dislocation"),
        ("'Dead arm' sensation",                     "Axillary nerve stretch, instability"),
        ("Reduced range of motion — global",         "Frozen shoulder (adhesive capsulitis)"),
        ("Weakness with elevation",                  "Rotator cuff tear, deltoid nerve injury"),
        ("Clicking / clunking",                      "Labral tear, AC joint, biceps tendon"),
        ("AC joint tenderness / step deformity",     "AC joint injury"),
    ]),
    ("SHOULDER — MECHANISM (from Campbell's Operative Orthopaedics)", [
        ("Direct blow to shoulder",                  "AC joint separation, clavicle fracture"),
        ("Abducted + externally rotated arm",        "Anterior glenohumeral instability / dislocation"),
        ("Fall on outstretched hand (FOOSH)",        "Proximal humeral fracture, clavicle, SLAP"),
        ("Overhead throwing sports",                 "SLAP tear, posterior instability, internal impingement"),
        ("High-energy collision sport",              "Bony Bankart / Hill-Sachs lesion (requires surgical treatment)"),
        ("Dislocation during sleep / overhead",      "Significant glenoid/humeral bone defect (Campbell's)"),
        ("Reduction by patient themselves",          "Subluxation or generalised ligamentous laxity"),
    ]),
    ("SHOULDER — INSTABILITY SPECIFIC (Campbell's Operative Orthopaedics)", [
        ("Direction of instability",                 "Anterior / posterior / multidirectional"),
        ("Amount of initial trauma",                 "High energy → bone defect"),
        ("Ease of reduction",                        "Self-reducing → consider laxity"),
        ("Recurrence with minimal trauma / midrange","Associated bony lesion"),
        ("Neurological symptoms (numbness/tingling)","Axillary nerve, brachial plexus"),
        ("Voluntary vs. involuntary subluxation",    "Voluntary → psychological component; avoid surgery"),
        ("Position causing instability",             "Abduction + ER → anterior; adduction + IR → posterior"),
    ]),
    ("SHOULDER — FUNCTIONAL ASSESSMENT", [
        ("Overhead activity demands",                "Work, sport, throwing"),
        ("Dominant arm involved",                    "Critical for treatment decisions"),
        ("Use of sling / splint",                    "Previous management"),
        ("Prior physiotherapy / injection",          "Response guides management"),
    ]),
    ("SHOULDER — RED FLAGS", [
        ("Fever + warm swollen joint",               "Septic arthritis — emergency"),
        ("Night pain at rest + weight loss",         "Malignancy"),
        ("Numbness / weakness radiating to hand",    "Cervical radiculopathy — examine neck too"),
        ("Chest pain with shoulder pain",            "Cardiac referred pain — exclude"),
    ]),
]
make_region_table(doc, "SHOULDER  –  Specific History Checklist", REGION_FILLS["SHOULDER"].replace("0x",""), shoulder_data)

# ─── SPINE ──────────────────────────────────────────────────────────────────
spine_data = [
    ("SPINE — SYMPTOM CHARACTERISATION", [
        ("Level / region of pain",                   "Cervical / thoracic / lumbar / sacral"),
        ("Axial (local) pain only",                  "Disc, facet joint, muscular — non-radicular"),
        ("Radiculopathy — dermatomal radiation",     "Disc herniation, foraminal stenosis"),
        ("Claudication (worse walking, better sitting)","Lumbar spinal stenosis"),
        ("Myelopathy — bilateral weakness / gait",  "Cervical / thoracic cord compression — URGENT"),
        ("Bladder / bowel dysfunction",              "Cauda equina syndrome — EMERGENCY"),
        ("Morning stiffness > 1 hour",               "Inflammatory spondyloarthropathy (AS)"),
        ("Pain aggravated by Valsalva / cough",      "Disc herniation / intrathecal pathology"),
        ("Pain worsening with extension",            "Facet joint / spondylolisthesis"),
        ("Pain worsening with flexion",              "Disc-mediated / vertebral fracture"),
    ]),
    ("SPINE — MECHANISM / ONSET", [
        ("Trauma — compression / flexion",           "Vertebral fracture — osteoporosis screen"),
        ("Insidious onset < 40 yrs + sacroiliac",    "Ankylosing spondylitis"),
        ("Post-operative / procedural",              "Haematoma, infection, hardware failure"),
        ("Lifting / twisting injury",                "Disc herniation, muscle / ligament strain"),
    ]),
    ("SPINE — NEUROLOGICAL SCREEN", [
        ("Numbness / paraesthesia — distribution",   "Map dermatome: L4=medial leg; L5=dorsum foot; S1=lateral foot"),
        ("Motor weakness — distribution",            "L4=ext. hallucis longus; L5=ext. hallucis longus; S1=plantarflexion"),
        ("Urinary retention or incontinence",        "Cauda equina — EMERGENCY"),
        ("Faecal incontinence / perineal numbness",  "Cauda equina — EMERGENCY"),
        ("Bilateral lower limb symptoms",            "Central disc, cord compression"),
        ("Upper motor neurone signs (spasticity)",   "Cervical myelopathy"),
    ]),
    ("SPINE — INFECTION / TUMOUR SCREEN (Miller's Review of Orthopaedics)", [
        ("Fever, rigors, night sweats",              "Spinal infection, discitis, epidural abscess"),
        ("IV drug use / immunocompromised",          "Osteomyelitis / epidural abscess risk factors"),
        ("Diabetes mellitus",                        "Increased infection risk"),
        ("History of TB / exposure",                 "Pott's disease (spinal TB)"),
        ("History of malignancy",                    "Vertebral metastasis"),
        ("Unintentional weight loss",                "Malignancy / infection"),
        ("Elevated ESR / CRP (if known)",            "Raised in infection > OA"),
        ("Back pain + fever + neurological deficit", "Epidural abscess — EMERGENCY surgical evaluation"),
    ]),
    ("SPINE — FUNCTIONAL ASSESSMENT", [
        ("Walking distance / tolerance",             "Claudication vs. arterial — cycling test"),
        ("Posture-dependent relief",                 "Flexed posture relief → stenosis"),
        ("Work / ADL limitation",                    "Chronic disability assessment"),
        ("Previous physiotherapy / injections",      "Response to treatment"),
        ("Prior spine surgery",                      "Hardware, adjacent level disease"),
    ]),
]
make_region_table(doc, "SPINE  –  Specific History Checklist", REGION_FILLS["SPINE"].replace("0x",""), spine_data)

# ─── HIP ──────────────────────────────────────────────────────────────────
hip_data = [
    ("HIP — SYMPTOM CHARACTERISATION", [
        ("Pain location — groin",                    "Intrinsic hip pathology (OA, AVN, FAI, labral)"),
        ("Pain location — lateral (trochanteric)",   "Greater trochanteric pain syndrome / bursitis"),
        ("Pain location — buttock",                  "Referred from spine / SIJ; piriformis"),
        ("Pain radiating to knee",                   "Hip pathology can refer to knee — examine both"),
        ("Limp (antalgic vs. Trendelenburg)",         "Antalgic = pain; Trendelenburg = abductor weakness"),
        ("Stiffness — loss of internal rotation",    "Earliest sign of hip OA"),
        ("Clicking / snapping sensation",            "Snapping hip (iliopsoas / IT band / labral)"),
        ("Pain with prolonged sitting",              "Femoroacetabular impingement (FAI)"),
        ("Groin pain with activity in young adult",  "FAI, labral tear, stress fracture"),
        ("Start-up pain (first steps)",              "OA, inflammatory arthritis"),
    ]),
    ("HIP — MECHANISM / ONSET", [
        ("Trauma — fall on greater trochanter",      "Femoral neck or intertrochanteric fracture"),
        ("Minimal trauma + osteoporosis",            "Insufficiency / pathological fracture"),
        ("Insidious — young active person",          "FAI, labral tear, stress fracture"),
        ("Insidious — older adult",                  "Osteoarthritis, inflammatory arthritis"),
        ("Sudden pain + inability to weight-bear",   "Fracture, acute AVN, acute labral tear"),
    ]),
    ("HIP — AVN RISK FACTOR SCREEN", [
        ("Systemic corticosteroid use",              "Most common non-traumatic cause of AVN"),
        ("Alcohol excess (> 400 mL ethanol/wk)",     "Fat emboli theory"),
        ("Previous hip dislocation / trauma",        "Disruption of blood supply"),
        ("Sickle cell disease",                      "Sickling in femoral head vasculature"),
        ("Radiation therapy to hip region",          "Radiation-induced vasculopathy"),
        ("Dysbaric conditions (diving)",             "Gas emboli"),
        ("Systemic lupus erythematosus",             "Vasculitis + steroid treatment"),
        ("Gaucher's disease",                        "Storage disorder → bone infarct"),
    ]),
    ("HIP — FUNCTIONAL ASSESSMENT", [
        ("Walking distance",                         "Quantify limitation"),
        ("Shoe / sock / toenail care",               "Loss of internal rotation impairs ADL"),
        ("Stair climbing",                           "Grading function"),
        ("Use of walking aid",                       "Stick (contralateral hand) = hip problem"),
        ("Sexual activity impairment",               "Important to document; impacts QoL"),
        ("Prior physiotherapy / injections",         "Response to treatment"),
        ("Expectations for treatment",               "Especially pre-operative planning"),
    ]),
    ("HIP — RED FLAGS", [
        ("Acute groin pain + fever + systemically unwell", "Septic arthritis — EMERGENCY: drain same day"),
        ("Hip pain + history of malignancy",              "Metastatic disease / pathological fracture"),
        ("Sudden inability to weight-bear after trivial fall", "Fracture (osteoporosis, malignancy)"),
        ("Night pain at rest + weight loss",              "Bone tumour / metastasis"),
        ("Pain in child + fever + limp",                  "Septic arthritis / Perthes / SUFE"),
    ]),
]
make_region_table(doc, "HIP  –  Specific History Checklist", REGION_FILLS["HIP"].replace("0x",""), hip_data)

# ══════════════════════════════════════════════════════════════════════════════
# SUMMARY / CLINICAL IMPRESSION
# ══════════════════════════════════════════════════════════════════════════════
doc.add_heading("C.  CLINICAL IMPRESSION & NEXT STEPS", level=2).runs[0].font.color.rgb = DARK_BLUE

summary_tbl = doc.add_table(rows=7, cols=2)
summary_tbl.style = "Table Grid"
labels = [
    "Working Diagnosis",
    "Differential Diagnoses",
    "Red Flags Identified",
    "Investigations Requested",
    "Referrals",
    "Management Plan",
    "Follow-up",
]
for i, label in enumerate(labels):
    set_cell_bg(summary_tbl.rows[i].cells[0], "2E6DA4")
    add_cell_text(summary_tbl.rows[i].cells[0], label, bold=True, size=9, color=RGBColor(0xFF,0xFF,0xFF))
    summary_tbl.rows[i].cells[0].width = Inches(1.8)
    add_cell_text(summary_tbl.rows[i].cells[1], "", size=9)
    set_cell_borders(summary_tbl.rows[i].cells[1])

# Footer
doc.add_paragraph()
footer_p = doc.add_paragraph("Sources: Miller's Review of Orthopaedics 9th Ed | Campbell's Operative Orthopaedics 15th Ed 2026 | Firestein & Kelley's Textbook of Rheumatology | Rockwood & Green's Fractures in Adults 10th Ed 2025")
footer_p.runs[0].font.size   = Pt(7)
footer_p.runs[0].font.italic = True
footer_p.runs[0].font.color.rgb = RGBColor(0x88,0x88,0x88)

# ── Save ──────────────────────────────────────────────────────────────────────
out_path = "/tmp/workspace/ortho-history/Orthopaedic_History_Form.docx"
doc.save(out_path)
print(f"Saved: {out_path}")