Locomotor: REMS

Question 1

What does REMS stand for?

Answer 1

Regional exam of the MSK system

Question 2

What does REMS examine?

Answer 2

Structure for joint/s examination

Question 3

Steps for REMS?

Answer 3

Introduction
Looking joint
Feeling joint
Moving joint
Assessing joint function

Question 4

What does step 1, looking at the joint, involve?

Answer 4

Check all joint surfaces - including back

Compare symmetry on both sides

Check for skin changes, scars, muscle bulk/wasting, swelling in and around joint

Question 5

What does step 2, feeling the joint, involve?

Answer 5

Temperature - compare with other side

Palpate joint line for any tenderness

Swellings for fluctuance, soft/firm/tender

If needed, effusion

Question 6

What does step 3, moving the joint, involve?

Answer 6

Testing full range of joint movements in all planes, comparing both sides

Test movements passively - you move

Test movements actively - patient moves

Question 7

What do you record if there’s restricted movement?

Answer 7

Mild, moderate or severe restriction

OR

Angle of restriction

Question 8

What do you ask the patient if there’s restricted movement?

Answer 8

What’s stopping movement? E.g.

• Pain
• Stiffness
• Weakness

Question 9

What does step 4, functional joint testing, involve?

Answer 9

Upper body - can they put their hand to mouth, above their head, pick up a coin?

Lower body - gait, sitting, standing

Question 10

What happens after testing for function?

Answer 10

Special tests for joint pathology

Consideration of other joints that need to be examined to fully assess the patient