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INTRODUCTION The components of the musculoskeletal (MSK) system include the bones, joints, ligaments, muscles and tendons as well as the neurological and vascular structures. A simple system allows a concise yet comprehensive history to be taken and a reliabl...

Learning objectives To understand how to: Take a comprehensive musculoskeletal history • Perform a structured and systematic musculoskeletal • examination

Look The inspection begins as soon as you enter the examination room. Look for any walking aids. Remember to look at the whole patient and not just at the joint of interest. For example: /uni25CF look at the hands for rheumatoid arthritis; /uni25CF look at th...

Lumbar spine Examination should include the pelvis, hips, lower limbs, gait and peripheral vascular system as well as the lumbar region. Irritation of nerves in the lumbar spine can mimic problems in the lower limb. Always consider referred pain.

Metatarsophalangeal joint Test extension (70–90°) by asking the patient to lift the toes to the ceiling and test flexion (45°) by pointing the toes to the floor. Normal toe-o ff requires 35–40° of dorsiflexion.

Midtarsal joint Hold the heel with one hand and move the forefoot medially - (adduction = 20°) and laterally (abduction = 10°) with the other hand.

Move There are three stages to assessing movement. The words used to describe a particular movement are shown in Table 35.3 /uni25CF Active . Ask the patient to move the joint within the limits of their pain. /uni25CF Passive . Move the limb or joint yourself...

Neurological Focus your examination on the C5 to T1 nerve roots. These supply the upper extremities ( Figure 35.5 ). Figure 35.5 Spurling’s test for cervical spine nerve root entrapment. The examiner turns the patient’s head to the affected side while extendin...

SPINE The spinal column consists of 33 vertebrae with 23 interver tebral discs. This is supported by numerous ligaments and paraspinal muscles. When observed from the front (coronal plane) with the patient standing and the hips and knees fully extended, the h...