The prevalence of rheumatic diseases in the general population justifies including a rheumatologic screening examination in the routine clinical examination of every patient. In this chapter, we will suggest a methodology for general clinical examination that includes all the organs and systems, with a generic assessment of the musculoskeletal system. The idea of the proposed sequence is to combine economy of time and effort with the greatest possible sensitivity. In rheumatology, this global examination serves as a screening method and is aimed at detecting any significant anomalies. We suggest using it systematically on all patients, regardless of the reason for their visit.
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Notes
- 1.
Bending forwards requires flexion not only of the lumbar spine but also limited flexion of the thoracic spine and particularly of the hips. Limited movement of the lumbar spine can be masked by good flexibility in the hips. By placing our fingers on the lumbar spine, we can assess the spine separately.
- 2.
When we force adduction or abduction, the pelvis swings to the same side. This movement apparently increases the lower limb’s amplitude of movement, but should not be attributed to the hip!
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da Silva, J.A.P., Woolf, A.D. (2010). The General Clinical Examination. In: Rheumatology in Practice. Springer, London. https://doi.org/10.1007/978-1-84882-581-9_6
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DOI: https://doi.org/10.1007/978-1-84882-581-9_6
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