orthopedic examination for all joints (upper & lower limbs)

Physical examination plays a central role in orthopedic diagnostics. Orthopedic examination is performed in the following sequence: inspection, palpation, determining the range of motion of the joint, focused neurological examination, and special tests to evaluate for a particular disorder. Inspection aims to reveal gross orthopedic abnormalities and associated findings (e.g., signs of inflammation or bruising). Palpation is performed to check for local temperature changes, tenderness, muscle bulk, and pulses on the vessels of the examined body part. Range of motion, a measurement of joint movement in angular degrees, is used to evaluate mobility. This article outlines examination techniques for the major parts of the musculoskeletal system, with the exception of the shoulder, which is covered in “Orthopedic shoulder examination.”

1. Exam ot orthe Pedic 3
==

SS 2 Feel
— Rosh i ied a
sen — hampa
= Bros me, = ten der ness,
= traction
= cosh PoP 3- Move
ae Bee
sm — Passive

Becks =

He SPeciol teem
EM deck
E- balas IM fome Sem

sPecia vests of
= Stoner sPecia test [EJ
AN go

AcsPortind test + wa wef
pray a Pr ft ro bi aes OR hee cbr ce CALL x

UPPer Los

à
[el eee N A
Mi Oe CaO ess

que lis gm Pain El Slider GSR al a ee sim
lation pe dere Los

Heron

— Par ot tess

— No Pain test
ARS envie hash mean + Peiner ae Rate fm eue ner
Spuding Test

‘Axial Cervical
} ‘Compression
Test =

2. E spre tenes amant
sneer tes
“ns ae se

Minen na lé”

AAA

Neu tes caia cop"
4 hunter A Hlenien dont BUN o seh des aa tte garde ny qi
ech SOU Pain 7% re test Ia Pen Si in da SA of ne ne

= Pain > + res 8

ne Ramp = test

AAA A teatraek pedis tendent

= Pests an hat Be
Shah 8 fe an

5 bey Pan A

An da do € na ios ne ale

APS pie ven e e andren

nr.

— FmPty Can test" Toner rest” cadenas
Panties BAB De 32 en 2€ + A
fe ve OS ach dei EX she si Ua Stee a, an
rar U Pin OL tee Pan Si saute Go
Pan ar re

— He Pan = ren a

AOS pes RN a nn

percata Con Se

om

3. os rest oe au
men nen ane à ae GANT ae Sider 3 Flexion ana
A in a on wb nl ges
= Panne te
E ¡el
A em Sumida sede tefmaPinatas ed

- ou,

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RS E guider sk
Flees al Pan A
eines a a
Sn CENT
Pas te ness nen AS ALP

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Fi

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NA fir sem où ge A A

a Pje A o PA
Net a BE du 349 a Paros Pain AS de

Pan + res
— He Pain = test
x Pos ave tax men Lebrun bene

aux

Fo sted re sw
Pe ays NEADS" heme DE E gel 31 ELI Eten Ad ta gi aH
Vala Sheet state Pin Svan dents Une Studer à flexion Go a Ce calls»

pin st a se at Rin sf

4. ponts reed

CHAN BUS EE à mides Ue wt abs lenin Selon 31 Abi = dam

Panel no hash OL Pain SN 101 A AO > Cad ta) sali gen
nn Tresen

= Pain > + test
de Pain pr tee Lau rar ZUR
Pes aves van men m wicers rendewais orton et weer?

' Se

Go Pash off fast * Steeler”
ory 2/08 gs af, tte bar gos 20 CS Ba deta call gar
VU PES D Pan FLA Shenker sh Me DD Geis As GE

= ren DP Ji

D
Sen
(eee zen Ress

I- BAY Press tes? Sods au bob At”
E DUAL NUR oy BLED Od

pe AS Sl in reo
= in a4 test

SS en
HPS wie hast mem Swe Ps X CAN > %

"MPAA AA
ask chen ap mieten
a gente nse

UA prea as (enone fee
EN
rra [e]

A pin ale nes 18 e |

5. L-Relocerien test L 5 pr We)

Fase er Car d ve » As Ch Shoulder at cde.

«Reloca tien 21 Ge St Slo “best oC Pre bens:
PU

© oF Armes un
ES

de me

«es

- War Ash uP test
Diva où nd Wa Se Biot tes Sleuder HM Hein Es hu Ce db A
Fest Ol lan Voigt Fest 3) spl hs zur
Scala amg > + test}
Ne Wns à he
KDoS ikive test men lg plevacio herve Inia SATA Nes ler Anacte? $

6. 2-E\oon Pecia\ reko

Actes low yest * Odd Fou
Sor Frtasim soy A Ge Ub» AN fJexien Sold A
test 31 fain So ds Fest st Ube 4 fam Ae aa
Pain > + fest
No Poin Dr pest a

ned AN hans mn Ls ihm di

B- Gather shea ten "one
Ber Bhi AP flexion Sow Où dle CARS 5 Uvist D Faden Sou x
€lboa > fain flo 1513 + kesh sl Clee Palm SV 101
“test a
en > best
le fa here a
A Pos Fire vest mem media OP; Chend iris:

C- Verga zon test Cros Wee gh ob AV)

elles ah Le use I Siders UT CR D Ua oi ect ales YO
EG Le shader ele Oi gb gael gore

D- SPeed test cons Digo

a Abluctien S DE Slider 5 Flexion % CoG ther 2%
Flexiond av U race SU szafla 51 dle vy
Pano be Frese IN Pan SUN ben Jt

“ren
— Pain —> + test a

— Ne Pin > te

AR Pos have est mem bicePs Tendenisis im tenio

7. 3- Mvist 6Peciat Yes

A-_ Cora Lumet Syndrome md A
— Phaens test
- Tit test
Derkan test

* Phalen's test

Es sx 5 a

wermess us sles dto BP OD gogo ce Alcs ll
Vblalo Sl is Li +pest 51 lolas Gk geo

sr Aesk
— Morones + tat

SS Pain the ding” > 7 Fest

Hess tive bes meh CaPel Fund Sy ndrome comPrestim on

das nerve mn

$e Pass in eurPat tame”

if
e

3

Kinet test
manoness » Pain

Bis ple dt ob A y coe pannel ot Babies Ye cores x
Lu these ste LM 3 Fiver yo gh GRU a les

These ot Mi yy Ws Yo WEY se voy
— A lin Numpness + test

— do Him > — fest

X Durkan Test

SRA ARAS
PE E ot Way
um nes + best

— He ty > Hash
HPsitive rest mean corbol fumas Sfndrome

8. B-Finkelstein test
frome NEL Way C Ect evsion
Vi 4 eat) Pin oft E

= Pan > + #884 best Sl vu

Se a

K Pos ihre Veoh Men De Queven's

AVIS Los Flexing af he een six
Ve, wann aha ge tun RT

C- Gand tes

a où A Dh Hed ot este QUES bor in Sa Hund ed

A Or heal org bib ge
= Pain + den

— de fa dest
A ES
O |

AS

wa often Ws de

9. SPecial tests of Leder Yimios
SS eee

1 Schober 's test € Gots voa pi,
gen labos us, poles | ena AG Gs Tee cvest M > 224

ice ALD ddr Lena Ww, Ww io
Bay es eds chee

ce di Cine KEANE
Wer Ca Ji Gl ad GD
Aes SN ob rin AN AG Eph ge Sore Sr seks ot De e an

on sen + ve

aoe 2
Sn he

O Us ae Vanes Reese
ea cid ey DN,

Ab, y A) e ls
MN Mat e alas ds

a a
A AA
A DOS itive test han AnnyloS09S Sandy

3-SLT Chr Le Fe noi e ü ol n
Leg pre cg cie laste Sia d knee + WP Sin
POSEAN A TS
Tech BL LA HA
— Pain "NP flexion sge” —>+ rest
ue Pan >= Ts

APO SNe est mean pera pere

A ena mes ea te QD hy a Pin phy RAE WY us nie
= ue m oats do

secs a gos E La a 02 Rin sn ces que er sen à
Area D db ee omy Sling eu nem ot ue

ieee 06 ar tine A

10. WEST (femsen Crv atch es)

E eae ab de ei oa ce CS x
SV Pare 95) ME A MP Extension av Pan Tf 151
Tata Pan cha Teer

Rn e ess a

nn
Y Rossi da men DISC Preta ESC line beck”
Sy

Wendelenoars Tess

a aa

E AA
A di Rat Arsen
aa GALA ERD ATER 1 Ed e

rest

= balance Ten
rennes + Test
Ses ms

AAA A conte mn be

KWOK ¿nn zn
mue NS

Blur!

va
G-Themmas Test ÍA
pad ll E sion san ll de ncaa
Ko orig eue cere ial laicas

Dh, om

riesen ee see bee en REA sense

SF rw geule vt

tee

— he Hip rest
XP dire dab mn NP Mein Li

= Tet sai de ws Lean
eee een ggg, BER gro

a Pain fot ke de MA mans J WEY assé at
se TEBE SH fe qe + ren al

— Pain > + test <j

Lu Ring dest
x Positive test men Seeraiviac Sent gua > Saorsiliis OB

11. ee

8- Sectoral Sign
Knee A flexion 82 9 WPA Florin ges jal de ar OL ow A x
Movs fresh A MP Pin sherds LP A radical Refahan te

res a1 Pum
— Pain After Tutemal Rotation —p * test a

RON

Positive test mew Ey AW of LP Sem

9- Pelar TaP Test
A A EI
A A aa e
PAE A AAN

trest Smee UP and Don thE TE SA St Win Sha mh ud

Hee ni oom > + ret el — | . spi
=

= Stable >- Test
x Positivo put man Pabelur Effusien=

lo- Pateller Grind Fest *Chendrenmatasie Pateta test?
dde bar de ly Phen 1 Ais Flexion E Gol Knee dis nah ide ab Ge Aw
Gr ScwPleie Frache DL rest + Hno 1G b JE asa y Patella 3
Al di Di VA AL ats QU GEM us Gy by Das tot be
AA Pain fus aah Sept qi Got + AA Pain ate sey

Bee a rt MAA a

Pr ASA

W-Velqus stress test
DRE er er ye ee

a oe ee
> ee ere a +

— Pain Amo were de nee AP des
or en
Positive test men mella Rel Liga joe

12. 12- ES Stvess Fest
BLM css ge Kwee NE 8 oP Hew bh cw six
Ay GS aie ke > “Late Side = Ankle 51 ide
Wat Test st oa were or gaP = Rin 1
nt BN fu

ge? Pen A wave in unse > + Tes

— Ne Hind >= He
A Positiva Rest wen Latent ladera Usama Aha

13 Anterior Drama test

Flexion % © sb knee ol „ab det GC Az
Ds) ee BES log food Sh Ol sue [51 publ ey

AL» Jos +%

Deus D Tin a mn en
ana

pen ia ta SY Aut EN

nee Meine biete at Test

— Me Thin — Ten

W Positive test mean ACL mg En me Ack ame

H- Posterior Drover test
+ OW Thin st #2 GW) ADT sted

Y Positive dest men PEL TT) te HSE PCL Shade
°

15-APles/s Distractien test .
Wr menü > viol It Cab leia 9S 296 knee Sl 6 pe er
Test fl res I fain À 191 Ideal + tend feb à BU tay LED eut >
— Pain + Tes?

ma “DE 5

TOON Bee) man Pain on mel ae ac ande Y

Pain en babel side LE Inu)

13. 16. AP ley ce nOvession Test

Gall Je ew ADT AB GIOw MELLA UD bi x
dde ga
x a

Abm F ge yl JS ¿Sal as
SU e I
Ge
PET
4425 J! 635 (supracondylar fracture of humerus #3 JS 2 yl) look Jo és à
(tenderness, temperature, pulse ) yg x8 352 Jia pa feel J eau
Yin Sia 2 is active Y passive) Self il ay
‘Tels! ce Jia 5 (fasciotomy) sde 545 compartments syndrome J! ce Use aa.

14. RTA JU gia
be Gee =)

ata le gala Y

Jee ous.

Sa All Y Sl A gS €

SIE hé Stal Bag gol) ly gt 0
Gen ph on y SHEN GA 5588) ai any 1

way
BRIEF RT ( 5 AN
PASS Js plas ¿dls já = D 3 ) ga cel
SMOOTHLY

Y doma ge e dal fate y gle SSM Le yde pall ce US gl
DS jas gs dig.)
¿ja qi VY

SS tase
del

Seal ge USS.)

daga

FIS gia JE ja ju ly GE SI eh AS Eu ASL 9) goa gi Las
En gs

Sa sal SNS gr 6 CH INS Gall Gan cd 8) GS D 6 ON 2

(Pal)

3

15. X-vey Reading en

v Pan kay
2 View CAP gr taten view

> Le» Ve a Sy
Y IES
5 gr gh san Ts
e ems) SANG Bone 31 Jo
Batace ex A
Pa Si oS Sl ist
3- ase UT
g- Vos je Bo
le A LS

es a Ss

Plain ay
Loteral View fer Righ fen

Hatwe vane

Key Shen Trans Veras Fracture

dis Plnemen Frnexnce

The dingpesis 35 Saba condylr Fracte tire y

BED ple JEW gl cs, si fe ui LÉ gb Mp

es ee cet AAA

16. Patient Positioning
Cheat Sheet

Lithotomy sa paient poston in which the patent is on thelr back
‘with hips and knees flexed and thighs apart

Trendelenburg's

rendelenburg's position involves lowering th head of he bed and
raising th foo of me Bed ofthe paient. Te patent's arms shouldbe
‘eked their sides

Reverse Trendelenburg's

Reverse Trendelenburg's is patient position wherein the the head
fe bed is elevated with the fot of the bed Gown. tis the
‘opposite of Trendelenburg's positon

Knee-Chest Position

Knee-<hes position, can be in stern or prone position. In steal the
patient es on Mer ide, tors les diagonal across the tae, pe
nd knees aro flexed. In prone, ho patient kneels onthe fable and.
Tower shoulders on to the fable o chest and fae rests onthe ae.

Jackknife Position

acknie postion, aso known as Kraske, is wherein the patients
‘abdomen es flat onthe bed. The bedi seissore so the hp is fte and
the legs and head are low.

Kidney Position

In Kidney position, the patient assumes a modified atera postion
wherein the abdomen placed over aif in the operating tabe that
‘ends the body Patent e tamed on Meir contralateral sido wth their
Back placed onthe edge ofthe fable,

17. Patient Positioning
Cheat Sheet

Supine (Dorsal Recumbent)

‘Supine position (dorsal recumbent is wherein he patient es flat
on he Back with head and shoulders sigh elevated using a pilow
unless contraindicated (ag, spinal anesthesia, spinal surgery.

Fowler’s (Low, Semi, and High Fowler’s)

Fowlers position, ls known s semi-siting position, is a bed position
Vihereinthe head of the bed e elevated 450 60 degree. Variations of
Fowler’ position include: low Fowlers 1510 30 degrees), semi-Fowler's
(6010.48 degrees and high Fowler's (near veria)

Orthopneic (Tripod)

Orthopneie or ipod position places the patient in a siting postion
‘ron he side ofthe bed ih an overbed able in front o len on
and several pilows onthe tablet est on

Inprone postion, the patient is onthe abdomen with head tuned | aa
tone side and the hips are not flexed,

Lateral (Side-Lying)

In atral position, the patient es on one side of thet ody with the top
leg in ron of the Bottom leg and the hip and knee fixe Flexing the
top Hip an knee and pacing tis le in front ofthe body creates wider,
trngulor base of support ond achieves greater stabil

Sim’s (Semiprone)

The patient assumes a posture halfway between the teal andthe
prone postions The lower arm is postfoned behing the cent, andthe
Upper arm flexed a the shoulder and the elbow The upper leg

‘more sure led at both the hip and the knee, than is the lower one,