PEMERIKSAAN FISIK DASAR KELAINAN ORTHOPAEDI

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Presentation transcript:

PEMERIKSAAN FISIK DASAR KELAINAN ORTHOPAEDI Dr. Hari Tjahyono, SpOT

DATA History Physical examination Photo Laboratorium

HISTORY Keluhan utama - Pain : - Nyeri - Anestesi - Parestesi - Penurunan fungsi - Physical Appearance - Deformity - Atrophy - Scoliosis - Relevant past history : penyakit sebelumnya - Penyakit penyerta : Jantung, ren, diabetus melitus, respiratory, psychic - Family history

Physical examination Body build : Wajah, gait (walking), duduk, tidur Looking (inspection) Feeling (palpation) Moving (Assessment of joint motion) Listening (auscultation) Special physical test Neurological examination

LOOK (INSPECTION) Warna kulit : merah, cyanosis, pigmentation, pucat, luka Swelling Limb shortening / atrophy Gait

FEEL (PALPATION) Hangat Dingin Size (ukuran) Dislocation Crepitus

MOVE (ASSESSMENT OF JOINT MOTION) Passive movement Joint instability Range of motion

LISTENING (AUSCULTATION) Crepitus Snapping tendon Murmur arteriorvenous fistula

PHYSICAL TEST Flexion deformity : Thomas test Trendelenburg test Instability: - Ortholani - Laseque Test - Mc Murray Test Neurological examination : - Muscle : Weakness Spasticity - Sensation - In coordination - Reflex tendon

RADIOGRAPHIC EXAMINATION Identitas pasien Tulang : AP Lateral melampaui kedua sendi Densitas naik : sclerosis Rarefaction General density, local density Hubungan tulang : dislocation, subluxasi Break in bone : fracture line (transfer, Oblique, segmental, comminutive, rotasi, cumcontractionum, cumdistractionum, angulasi) General / local countour : Deformity, Irregularity

RADIOGRAPHIC EXAMINATION Sendi Articular cartilage : Space sendi Soft tissue Comparation of a limb Special photo : contras / medium Arthrogram : dalam sendi Myelogram : sub arachnoid Sinosgram : dalam sinus CT Scan MRI Bone Survey

LABORATORIUM EXAMINATION Darah lengkap Leukocyte, LED, Thrombocyte, HB Serum : Mantoux (TBC) Rose test (Rheumathoid desease) Urine : - Albumin, gula, cell, kristal - Cultur Cerebro spinal fluid : Protein, cell, Cultur Abnormal fluids : Effusion, Exudates Gross, smear, cultur, resistance antibiotic

Semua data dikorelasikan untuk diagnose dan diferensial diagnose BODY TISSUE Gross Biopsi Semua data dikorelasikan untuk diagnose dan diferensial diagnose

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