Examination of wrist and hand
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Clinical examination of wrist and hand (orthopedics posting) I do not own this file. Courtesy to Dr Madhusudhan, BBH Orthopaedics
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Wrist and hand examination
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
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2) The physical examination involves inspecting the hip from various angles, palpating bony landmarks and soft tissues, measuring range of motion, assessing limb length and muscle bulk, and performing stability and special tests.
3) A number of special tests are described that can help identify conditions like labral tears, femoral anteversion, and soft tissue contractures. Taking a thorough history and conducting a complete physical exam are important for accurately diagnosing hip joint pathology.
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The document outlines the process for examining a patient's shoulder, including inspection, feeling for tenderness and temperature, assessing range of motion actively and passively, and performing special tests. Key steps are introducing yourself to the patient, gaining consent, exposing the joint, systematically examining alignment, skin, muscles, and bones. A variety of special tests are described to check for impingement, rotator cuff pathology, instability, biceps issues, AC joint problems, and thoracic outlet syndrome. The exam is completed by examining adjacent joints and neurovascular status.
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This document provides an overview of how to examine the hip joint through inspection, palpation, range of motion tests, and special tests. It discusses examining the hip for conditions like developmental dysplasia of the hip, septic arthritis, transient synovitis, Perthes disease, and more. Key parts of the examination include inspecting for deformities, palpating for tenderness, performing range of motion tests to evaluate movements like flexion and rotation, and special tests like Thomas test and Trendelenburg test to assess for instability. Close inspection and accurate examination of the hip are important for correctly diagnosing various hip joint pathologies.
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The document provides information on clinical examination of the hip joint. It begins with anatomy of the hip joint and associated muscles and ligaments. It then discusses elements of history taking including pain characteristics. The physical examination section covers inspection of gait, limb posture and length, palpation of bony landmarks and muscles, range of motion testing, and special tests like Trendelenburg test. Measurements of limb length discrepancies both apparent and true are also described.
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Wrist and hand examination
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
Examination of hip joint
1) The document discusses the process for examining a patient's hip joint, including obtaining history, performing physical examination, and conducting specific tests.
2) The physical examination involves inspecting the hip from various angles, palpating bony landmarks and soft tissues, measuring range of motion, assessing limb length and muscle bulk, and performing stability and special tests.
3) A number of special tests are described that can help identify conditions like labral tears, femoral anteversion, and soft tissue contractures. Taking a thorough history and conducting a complete physical exam are important for accurately diagnosing hip joint pathology.
examination of foot and ankle
Dr. Manoj Das' document provides an overview of examining the foot and ankle. It discusses the anatomy of the foot and ankle including bones, joints, ligaments and muscles. The examination involves taking a history, observing gait, posture and deformities, palpating for tenderness, and assessing range of motion, neurovascular status, and performing special tests. The goal is to assess, diagnose and treat conditions of the foot and ankle.
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This document provides information on examining, evaluating, and assessing the hand and wrist. It begins with objectives of reviewing clinical anatomy, performing a physical exam, and discussing common clinical conditions. It then covers anatomy of the bones, joints, muscles, nerves and blood vessels of the wrist and hand. The document provides details on the history, inspection, range of motion assessment, neurologic exam, and special tests like Tinel's sign and Phalen's test used to evaluate common conditions like carpal tunnel syndrome.
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The document outlines the process for examining a patient's shoulder, including inspection, feeling for tenderness and temperature, assessing range of motion actively and passively, and performing special tests. Key steps are introducing yourself to the patient, gaining consent, exposing the joint, systematically examining alignment, skin, muscles, and bones. A variety of special tests are described to check for impingement, rotator cuff pathology, instability, biceps issues, AC joint problems, and thoracic outlet syndrome. The exam is completed by examining adjacent joints and neurovascular status.
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This document provides an overview of how to examine the hip joint through inspection, palpation, range of motion tests, and special tests. It discusses examining the hip for conditions like developmental dysplasia of the hip, septic arthritis, transient synovitis, Perthes disease, and more. Key parts of the examination include inspecting for deformities, palpating for tenderness, performing range of motion tests to evaluate movements like flexion and rotation, and special tests like Thomas test and Trendelenburg test to assess for instability. Close inspection and accurate examination of the hip are important for correctly diagnosing various hip joint pathologies.
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This document summarizes the steps for examining a patient's shoulder, including inspection from multiple angles to identify scars, swelling, alignment and muscle wasting. It describes palpating various parts of the shoulder joint. Range of motion and special tests are outlined to assess the rotator cuff, impingement, AC joint, biceps, deltoid, serratus anterior and instability. Specific tests described include Neer's sign, Hawkin's sign, Jobe's test, belly-press test, apprehension test and relocation test. The examination provides a thorough evaluation of the shoulder to identify any injuries or limitations.
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This document provides guidance on performing an orthopedic examination of the shoulder. It outlines the basic steps as look, feel, move, and special tests. For the shoulder examination, it emphasizes tailoring the exam based on suspected problems such as instability in young patients or impingement/rotator cuff tears in older patients. Key parts of examination include inspection for deformities or wasting, palpation of bony landmarks and soft tissues, and assessing the full range of motion including any painful arcs. Special tests are described to detect impingement, specific rotator cuff injuries, or instability. The document stresses performing the exam with knowledge of anatomy and potential diagnoses to both prove and rule out clinical findings.
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Examination evaluation & Assessment of Ankle & Foot
Examination evaluation & Assessment of Ankle & Foot Lady Reading Hospital-Medical Teaching Institution, Peshawar
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The document provides information on examining the hand, including:
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2. Common disorders that can affect the hand such as congenital issues, trauma, infections, inflammation, and tumors.
3. Details on performing a thorough examination of the hand including inspection, palpation, range of motion testing, and special tests to evaluate arteries, tendons, nerves, and ligament stability.
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The document outlines the process for examining a patient's shoulder, including:
1) Inspecting for deformities, swelling, atrophy, and other abnormalities.
2) Palpating bony landmarks and soft tissues to check for tenderness.
3) Testing the full range of motion both actively and passively while observing for pain.
4) Performing special tests to isolate specific structures like the rotator cuff muscles and labrum.
5) Examining other joints and the neck for full evaluation of the shoulder.
6) Ordering relevant x-rays to assess for fractures or other bone abnormalities.
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Examination of shoulder joint
Clinical examination of shoulder joint (orthopedics posting)
I do not own this file. Courtesy to Dr Madhusudhan, BBH Orthopaedics
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This document summarizes the steps for examining a patient's shoulder, including inspection from multiple angles to identify scars, swelling, alignment and muscle wasting. It describes palpating various parts of the shoulder joint. Range of motion and special tests are outlined to assess the rotator cuff, impingement, AC joint, biceps, deltoid, serratus anterior and instability. Specific tests described include Neer's sign, Hawkin's sign, Jobe's test, belly-press test, apprehension test and relocation test. The examination provides a thorough evaluation of the shoulder to identify any injuries or limitations.
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This document provides guidance on performing an orthopedic examination of the shoulder. It outlines the basic steps as look, feel, move, and special tests. For the shoulder examination, it emphasizes tailoring the exam based on suspected problems such as instability in young patients or impingement/rotator cuff tears in older patients. Key parts of examination include inspection for deformities or wasting, palpation of bony landmarks and soft tissues, and assessing the full range of motion including any painful arcs. Special tests are described to detect impingement, specific rotator cuff injuries, or instability. The document stresses performing the exam with knowledge of anatomy and potential diagnoses to both prove and rule out clinical findings.
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This document discusses the examination of patients presenting with long bone nonunions or limb length discrepancies. It outlines the key components of history taking including chief complaints, history of presenting illness, and relevant medical history. The physical examination is described in detail, including inspection of the bone and surrounding soft tissues, palpation of the bone focusing on sites of tenderness, irregularity and mobility, assessment of range of motion, measurements, and deformity. Relevant investigations including laboratory tests, x-rays and potential special investigations like MRI are also mentioned. The document provides guidance on documenting anatomical location of involvement and pathological diagnosis.
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This document describes various physical examination tests for the lower leg, ankle, and foot. It provides procedures and implications for tests that assess the neutral position of the talus, leg and foot alignment, tibial torsion, ligamentous instability, and other conditions. Key tests include those for the anterior drawer test of the ankle, tibial torsion in sitting and supine positions, leg-heel alignment, and Feiss line to assess for flat foot. The document contains detailed steps for examiners to accurately perform various physical exams of the lower extremity.
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The document provides information on examining the hand, including:
1. The complex anatomy of the hand involving skin, ligaments, bones, joints, tendons, nerves, and vessels.
2. Common disorders that can affect the hand such as congenital issues, trauma, infections, inflammation, and tumors.
3. Details on performing a thorough examination of the hand including inspection, palpation, range of motion testing, and special tests to evaluate arteries, tendons, nerves, and ligament stability.
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The document outlines the process for examining a patient's shoulder, including:
1) Inspecting for deformities, swelling, atrophy, and other abnormalities.
2) Palpating bony landmarks and soft tissues to check for tenderness.
3) Testing the full range of motion both actively and passively while observing for pain.
4) Performing special tests to isolate specific structures like the rotator cuff muscles and labrum.
5) Examining other joints and the neck for full evaluation of the shoulder.
6) Ordering relevant x-rays to assess for fractures or other bone abnormalities.
Fracture of Shoulder and Humerus
This document discusses injuries to the shoulder girdle and humerus, including acromioclavicular injuries, dislocations, and fractures of the clavicle. It describes the mechanisms of various injuries, methods of diagnosis including physical exam findings and x-rays, and approaches to treatment including closed reduction techniques and immobilization methods. Reduction methods like Kocher's are outlined step-by-step for anterior shoulder dislocations. Greenstick fractures are noted as common in children. Immobilization with a sling or ring method is generally recommended for clavicle fractures and injuries requiring support.
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2) Treatment begins conservatively with anti-inflammatories, cortisone injections, and physical therapy. If unsuccessful, surgery such as open or arthroscopic acromioplasty is recommended to remove bone spurs and widen the space.
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The document provides guidance on performing a musculoskeletal examination, including general considerations, inspection, palpation, range of motion testing, and examination of specific areas like the shoulder, elbow, and hand/wrist. Key steps include inspection for deformities, discoloration, palpation for temperature changes and tenderness, assessing active and passive range of motion, and performing special tests if abnormalities are suspected. The exam should be compared between sides.
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- 2. Page2 Bony palpation;- Palpate lower end radius and ulna , look for the following findings – angulation,displacement(dorsal , lateral ), irregularity, broadening, thickening, Crepitus , step sign (step up sign –colles#, stepdown sign –smiths#) Joint line palpation;- pass finger along the lowerend radius the first depression u see is joint line , look for tenderness (RA, keinbocks , I/A #s) Relative position of two styloid process and DRUJ subluxation (do piano sign). Palpation of carpal bones- scaphoid , lunate, etc Palpation of metacarpals, phalanges, MOVEMENTS :- check for the movements and also note-is it painful, Crepitus,l oss of movement, lag, critical arc. Palmar flexion 0-90deg FCR, FCU MEDIAN NERV FDP,FDS(ASSIST) Dorsiflexion 0-80 deg ECRL, ECRB, RADIAL EDC,EI Ulnar deviation 25-35 deg FCU ULNAR Radial deviation 15-25 deg FCR,ECRB MEDIAN,RADI APL,EPB Pronation 0-90 deg PRO,TERES, QUAD ANTR INTEROSS NER Supination 0-90 deg BICEPS,SUPIN C5-C6 MEASUREMENTS ;- Linear and circumferential . Linear;- forearm- tip of lateral epicondyle to tip of radial styloid by convention Circumferential – take a fixed mark from a bony point where there is maximum bulk of muscle ,and take circumference of the FA to check for wasting. DEFORMITY ASSESMENT :- look for Dorsal angulation and radial deviation NEUROVASCULAR AND LYMPHATIC EXAMINATION;- Look for distal pulses, radial , ulnar, and the nerves, and regional lymph node examination. SPECIAL TESTS;- Phalens and reverse phalens test for CTS. Grind test;- for MCP &IP (trapeziometacarpal arthritis) Finkelsteinn test- for De quervians . DRUJ instability;- piano key sign and DRUJ compression test . Carpal instability –Scapholunate instability- Watson shift test,scapholunate ballotment. Linotrequitral instability-Ballotment test /reagen test. DIAGNOSIS;-ANATOMICAL- which part is involved joint, metacarpal, phalanx,carpal bones PATHOLOGICAL- synovitis, arthritis, dislocation,instability, malunion . INVESTIGATIONS;- LABORATORY – Hb,Wbc, TcDc,ESR,CRP RADIOLOGICAL –plain x ray of wrist AP & Lat, hand x ray-AP & Oblique SPECIAL INVESTIGATION-MRI-in carpal instability.