Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- History taking
- Abdominal examination
- Examination of the respiratory system
- Examination of the vascular system
- The orthopaedic examination
- Examination of the cardiovascular system
- Examination of the nervous system
- Appendices
- Index
The orthopaedic examination
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- History taking
- Abdominal examination
- Examination of the respiratory system
- Examination of the vascular system
- The orthopaedic examination
- Examination of the cardiovascular system
- Examination of the nervous system
- Appendices
- Index
Summary
The examination of any joint essentially involves three components:
General approach
LOOK – assess
▪ Alignment – is there any deformity or shortening; is there any unusual posturing of the joints and limbs at rest?
▪ Joint contour – are there any generalized or localized joint swellings? Are there any effusions?
▪ Scars and sinuses – are these from previous surgery or injury? Injury tends to produce an irregular scar, while a previous operation is suggested by a linear scar.
▪ Skin.
▪ Muscle wasting.
FEEL – assess
▪ Skin temperature – compare one side to the other. Is there any warmth or coldness (warmth is suggestive of inflammation)?
▪ Swellings – determine whether these are diffuse joint swellings or bony anomalies.
▪ Tenderness.
▪ Measurements.
MOVE – assess
▪ Active movement.
▪ Passive movement.
To complete the examination, measure relevant limb lengths, examine the joint above and below, performa full neurovascular exam of the limb, assess the gait, and obtain two X-ray views of the joint in question.
Examination of the upper limb
Here we will consider the elbow and wrist regions.
ELBOW
LOOK – for
▪ Deformities:
▪ Cubitus varus (or ‘gunstock’ deformity; this is most obvious with the elbow extended and the arms elevated, and is most commonly caused by malunion of a supracondylar fracture).
▪ Cubitus valgus (common in non-union of a fracture of the lateral condyle).
▪ Olecranon bursitis – the olecranon bursa occasionally becomes enlarged due to pressure or friction. When associated with pain is more commonly due to infection, gout, or RA.
▪ Swelling.
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- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 759 - 766Publisher: Cambridge University PressPrint publication year: 2009