Examination techniques used for muscle and
joint pain
1. Observe gait and posture; look for asymmetry
2. Look for discoloration, swelling, masses
3. Look for gross deformity, bony enlargement, alignment contour, symm
...
Examination techniques used for muscle and
joint pain
1. Observe gait and posture; look for asymmetry
2. Look for discoloration, swelling, masses
3. Look for gross deformity, bony enlargement, alignment contour, symmetry
4. Palpate inflamed joints last
Note heat, tenderrness, swelling, crepitus,
Spinal deformities noted during examination
1. Lordosis...obesity or pregnancy
2. Kyphosis...over curvature of the thoracic vertebrae
3. Scoliosis...curved from side to side
• Characteristic examination findings for
Rheumatoid Arthritis
Rheumatoid Arthritis
A chronic inflammatory disorder of the synovial tissue surrounding the joints.
· Found in younger adults; anorexia and weight loss
· Morning stiffness of small joints of the hands and feet,swelling, for at least one hour before
improvement; pain not relieved with rest.
· progressive fatigue with onset 4 to 5 hours after rising
· Symmetrical arthritis of same joint
· Fever, rheumatoid nodules, deviation of wrists
· Spindle-shaped fingers caused by painfulswelling of the proximal interphalangeal joints
· In the elbow: subcutaneous nodules along pressure points of the ulnarsurface (or may be indicative
of gouty tophi)
· Medium to fine crepitus noted
· Involved joints include hands, wrists, feet, ankles, hips, knees, and cervical spine.
· Synovitis with soft tissue swelling and effusions are present on physical exam
· Diagnostics: ESR: increased CBC: normochromic, normocytic anemia rheumatoid factor: positive
radiograph: bony erosion at the joint margins and joint deformities
· Diagnostic criteria for RA (must have at least 4 criteria to be present):
§ Morning stiffness least one hour before improvement for more than 6 weeks
§ Arthritis of 3 or more joints for more than 6 weeks
§ Arthritis of hands and joints for more than 6 weeks
§ Symmetrical arthritis of same joint
§ Rheumatoid nodules
§ Positive serum rheumatoid factor
§ Radiographic changes showing erosions or bony decalcification
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