Musculoskeletal Exam

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General: Preparation, Inspection, Palpation

  • Patient in gown or loosely dressed
  • ALWAYS begin each joint exam with inspection for asymmetry, deformity, atrophy
  • ALWAYS compare each joint and muscle group bilaterally
  • Palpate each joint and muscle group in sequence
  • Isolate each axis when testing ROM

Special Considerations

  • Identify 6 cardinal signs of musculoskeletal disease: pain, redness, swelling, warmth, deformity, loss of function

Strength Testing Against Resistance

  • Abduct shoulder
  • Flex and extend elbow
  • Spread fingers
  • Flex hips
  • Flex and extend knee
  • Dorsiflex and plantarflex ankle

Neck

  • Palpate over each spinous process and paraspinous muscle groups
  • Measure ROM in 6 axes

Shoulder

  • Palpate: clavicle; A/C joint; corocoid process; scapula; glenohumeral joint; long head of biceps
  • Measure ROM in 6 axes (active and passive): abduction, adduction, flexion, extension, internal rotation, external rotation

Special Considerations: Shoulder

  • Drop arm test
  • Impingement sign

Hand

  • Palpate interphalangeal joints
  • Perform ROM (active and passive) of wrist, thumb, and fingers; isolating each axis of motion
  • Thumb abduction and opposition

Special Considerations: Hand

  • Identify and test for tenderness in anatomical snuffbox
  • Profundus and Superficialis Tendon tests

Back

  • Palpate over each spinous process and paraspinous muscle group
  • Palpate sacroiliac joint
  • Measure ROM (active) in 6 axes

Special Considerations: Back

  • Straight Leg Raises Bilaterally
  • "FABER" (Flexion, ABduction, External Rotation) Test Bilaterally

Knee

  • Palpate: distal femur and muscles; medial and lateral joint lines; patella and tendon; patella with movement; tibial tubercle; head of fibula; popliteal fossa

Special Considerations: Knee

  • Collateral Ligament Testing
  • Lachman's Test
  • Drawer Test
  • Major and minor effusion tests

ONLINE PHYSICAL EXAM TEACHING ASSISTANT

The UF College of Medicine Harrell Center