Physical Examination of the Musculoskeletal System
Musculoskeletal system consists of bones, skeletal muscles, ligaments, tendons, cartilages and other connective tissues, and joints are the fundamental functional unit. The primary methods used for physical examination of musculoskeletal system are inspection and palpation. Percussion and auscultation are only used in special situations such as percussion pain of vertebrae, auscultation for bone crepitus. The examination should include assessment of muscle strength and range of motion and maneuvers to test joint function and stability. Both active movements (where the patient moves the joint themselves) and passive movements (where the examiner moves the joint) should be performed. Notice the symmetry, looking for symmetry of involvement and noting any joint deformities or malalignment of joints or bones. Examination should also include assessment of surrounding tissues, noting skin changes, subcutaneous nodules and muscle atrophy, and assessment of inflammation especially redness, swelling, warmth and tenderness. Use the back of your fingers to compare the involved joint with its unaffected contralateral joint, or with nearby tissues if both joints are involved.