MUSCULOSKELETAL SYSTEM HISTORY AND PHYSICAL

EXAMINATION DR. WALEED HADDAD

ASS. PROF

CONSULTANT ORTHOPAEDICS

HAND AND UPPER LIMB SURGEON

SPECTRUM

• Signs and symptoms of conditions affecting the musculoskeletal system including

• Inflammatory joint diseases

• Degenerative

• Crystal depositions

• Traumatic condition orthopaedics

Signs “pain”

• Analyse as usual (site, duration, periodicity, severity, increasing and relieving factors …)

• Site: • mono, oligo or polyarticular

• Large or small joints

• Upper or lower limbs

• Symmetrical or asymmetrical

• At the same time or migratory

Stiffness

• Decrease range of movement • true

• Painful movement

• Difficult to move

• Morning stiffness: >30 min

Other local symptoms

• Swelling

• Erythema

• Locking

• triggering

Extra Articular Symptoms

• Rash: psoriatic, erythema nodosum, malar rash, photosensitivity

• Raynauds phenomenon

• Sicca syndrome (eye and mouth dryness)

• Moth ulcers

• dysphagia

Examination

• Look

• Feel

• Move

• Special tests

Look

• General • Eye

• Mouth

• Skin

• Genetal

• local

Local Inspection

• Swelling

erythema

Deformity

nodes

• Rheumatoid nodules

• Heberden’s

• Bouchard’s

Feel

• Temrature

• Tenderness

• Masses

• Synovial thickening

Range of movement

• All joints involved

• Referring distal part movement or from neutral

Special test

• Knee effusion • Patellar tap

• Milking sign

• Stability tests

• …….