History & Physical Examination of Joints Anousheh Haghighi MD. Rheumatoligist

Questions:  Is the problem Regional or generalized, symmetric or asymmetric, peripheral or central?  Is it an acute, sub-acute or chronic problem? Is it progressive?  Is it inflammatory or non-inflammatory?  Is there evidence of a systemic process? Are there associated extra-articular features?  Is there a family history of a similar or related problem?

Principles of Rheumatologic Examination  Examination of Joints Muscles Tendons Skin & Nails and a complete systemic examination...

Examination of Joints  Inspection: Erythema, Swelling, Deformity  Palpation: Tenderness, Warmness  Range of motion  Effusion

Important physical signs of arthritis  Swelling: Effusion, Synovial thickening, Soft tissue inflammation, Bony enlargement, Extra-articular fat pad  Tenderness: Unusual sensitivity to touch  Limitation of motion  Crepitaion:A palpable or audible crunching sensation produced by motion  Deformity: Malalignment of joints  Instability: is present when the joint has greater than normal movement in any plane.

Examination of Specific Joints

Upper Extremity

Hand

Lower Extremity