Clinical History

Abstract

The history and physical examination not only provide important diagnostic information, but also determine the nature and extent of subsequent investigations. In addition, these two elements of the musculoskeletal data base may be of value in identifying the aetiology and severity of the disease as well as the patient’s prognosis. In certain conditions, e.g. fibromyositis, subacromial bursitis and flexor tenosynovitis, the only clues to diagnosis are those detected during the clinical assessment, since radiographs and laboratory tests are characteristically normal. In other diseases, e.g. a classical case of primary osteoarthritis, ancillary tests may be required to define the severity of disease and establish clinical priorities, but may not be essential for diagnosis. Finally, there are a number of diseases, e.g. polyarteritis nodosa and pigmented villonodular synovitis, in which a diagnosis can only be made by supplementing clinical information with the results of specific laboratory tests.