- Do you have any pain or stiffness in your muscles, joints and back?
- Can you dress yourself completely without any pain or difficulty dressing yourself?
- Do you have any pain or difficulty walking up and down stairs?
"Can you please walk to the other side of the room for me, and then come back?" Watch for:
- and Ease of Turning.
- Shoulder muscle bulk
- Straight, central spine.
- Level Iliac crests
- Gluteal muscle bulk
- Popliteal swelling
- Calf muscle bulk
- Hind foot abnormalities.
Inspect for normal:
Hip and Lumbar Flexion
"Can you please try to touch your toes?" Let them do it with two of your fingers on the lumbar spine; there should be some separation of your fingers during flexion.
Front view (anatomical position)
- Level Shoulders
- Bilateral Muscle Bulk
- Elbow extension
- Quadriceps bulk and symmetry
- Knee swelling and deformity
- Foot arches, and any midfoot or forefoot deformity.
Head and Neck
"Try to touch your ear to your shoulder, on both sides."
- Lateral flexion of the cervical spine
"Open jaw wide, and move it side to side."
- Assessment of the tempero-mandibular joint
"Arms behind head, then down again, with elbows by side, then turn around to the front, end with palms facing down."
- Full shoulder abduction, then external rotation, and finally supination at the elbow.
- Inspect for swelling and deformity of wrists and hands
- Inspect the palms of the hands for muscle bulk, and any visual deformities
"Can you clench your fist?"
- Looking for dupiter’s contracture
- Assesses wrist and hand mobility
"Can you squeeze my fingers?"
- Tests Power
"Can you touch fingers together one after another?"
- Hand-joint movement
- and Concentration
Finally, gently squeeze the metacarpal pharyngeal joints
- Screening for inflammatory joint disease
Whilst patient is on examination couch, lift the leg with a bent knee, to test hip extension and knee flexion, and whilst up turn it, to check internal and external rotation.
Feet and Legs
Perform a patella tap
- To exclude knee effusions.
Examine soles of feet
- Looking for callus formation.
Finally squeeze metatarsals.
- To screen for inflammatory arthritis