Musculoskeletal assessment Orthopedic assessment


Patients present with a variety of conditions, and assessment need to be adopted to suit their needs. This section provides a basic framework for the subjective and physical musculoskeletal assessment of a patient. 

Subjective Examination
Body chart
Location of Current symptoms
Type of pain
Depth, Quality, Intensity of symptoms
Intermittent or Constant
Abnormal sensation (e.g. pins and needles, numbness) 
Relationship of symptoms
Check other relevant regions

Behaviour of symptoms
Aggravating factors
Severity
Irritability
Daily activities/Functional limitations
24-hour behaviour (night pain) 
Stage of the Condition

Special Questions
Red flags
Spinal cord or cauda equina symptoms
Bilateral extremity numbness/pins and needles
Dizziness or other symptoms of vertebrobasilar insufficiency (diplopia, drop attacks, dysarthria, dysphagia, nausea) 

History of present condition
Mechanism of injury
History of each symptomatic area
Relationship of onset of each symptomatic area
Change of each symptoms since onset
Recent X- ray or investigations

Past medical history
Relevant medical history
Previous episodes of present complaint
Previous treatment and outcome
General health
THREAD (Thyroid disorders, heart problems, Rheumatoid arthritis, Epilepsy, Asthama Or other respiratory problems, Diabetes) 

Drug history
Current medication
Steroids
Anticoagulants
Allergies

Social and family history
Age and gender
Home and work situation
Dependants
Hobbies and activities
Exercises
Yellow flags

Physical Examination
Observation
Posture
Function
Gait
Structural abnormalities
Muscle bulk and tone
Soft tissues

Active and passive joint movement
Active and passive physiological movements
Joint effusion measurement

Muscle tone
Muscle Strength
Muscle control and Stability
Muscle length
Isometric muscle testing

Neurological tests
Integrity of the nervous system
  • Dermatomes
  • Reflexes
  • Myotomes
Mobility of the nervous system
  • Straight leg raise
  • Slump test
  • Slump knee bend
  • Passive neck flexion
  • Upper limb neurodynamic tests
Special tests (eg.Coordination) 

Palpation
Skin and Superficial soft tissue
Muscle and tendon
Nerve
Ligament
Joint
Bone
Joint integrity test
Passive accessory movement. 

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