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DIAGNOSIS OF MUSCULOSKELETAL
DISORDERS AND INJURIESDEBORA LUSIANA HERMAN
11 2014 052
CLINICAL HISTORY
• Preliminary Data
• The Presenting Problem or Chief Complain
• Common Musculoskeletal Symptoms
• Relevant Past History
• Social, Economic. And Work History
• Family History
COMMON MUSCULOSKELETAL SYMPTOMS
Pain• Radiating pain and
referred pain • Onset, location, Character,
Severity, Duration, Factors that relieve the pain as well as those that aggravate it.
Decrease in function• Muscle weakness or
fatigue• Instability of a joint• Stiffness of a joint
Physical appearance• Deformities • Abnormal way of walking
(limp or abnormal gait)
PHYSICAL EXAMINATION
• LOOKING
• FEELING
• MOVING
• AUSKULTATION
• Special Physical Test
• Neurological Examination
Looking (inspection)
•Habitus and facies •Skin (redness, cyanosis, pigmentation)•Atrophy, hipertrophy•Deformity •Swelling
Feeling (Palpation)
• Skin temperature• Pulse•Tenderness•Swelling •Lump or mass•Dislocation
Moving (Assessment of joint motion)
•Active movement•Passive movement• ROM
Listening (Auscultation)•Fracture crepitus•Joint crepitus •Murmur of a peripheral arteriovenous fistula
SPECIAL PHYSICAL TEST
• Thomas Test
• Trendelenburg Test
• Barlow test and Ortolani Test
• Lasegue’s Test
• McMurray Test
• Hip Flexion Deformity
• Ineffectual hip adduction mechanism
• Instability of newborn hip
• Sciatic nerve irritation
• Torn medial meniscus of the knee
NEUROLOGICAL EXAMINATION
Importance when there is evidence of:
• Muscle weakness or spasticity
• Involuntary movements of muscle
• Symptoms of altered skin sensation
• Incoordination of movement
• Loss of balance
Examination includes assesment of:
• Motor System (muscle tone, power, coordination)
• Sensory System (pain, temperature. position sense, vibration)
• Reflexes (tendon reflex, abdominal reflex, plantar reflex)
• Rectal sphincter tone
DIAGNOSIS IMAGING
Plain Conventional Radiography
X-ray using contrast media
CT Scan Ultrasonography
PLAIN CONVENTIONAL RADIOGRAPHY
• General density of bone
• Local density of bone
• Dislocation
• Frakture
• Deformity
• Swelling
• Atrophy
LABORATORY
•HB,RBC, WBC, LED•Uric acid , blood cultureBlood• Serum calcium, inorganic phosphate, alkaline phosphate, acid phosphate, protein value• Immunological or serological test Serum• Gross appearance• Determination of albumin, glucose, cells, calcium, and phosporus •Urine cultureUrine• Gross appearance • Protein levels • CultureCerebrospinal fluid•Gross appearance and cells •Protein and glucose levels •CultureSynovial fluid