MSK examination

Question 1

What important locomotor problems do you need to consider with MSK problems

Answer 1

Pain

Tenderness

Swelling

Stiffness

Deformity

Weakness

Wasting

Loss of function

Extra-articular features

Question 2

Cardinal symptoms of joint problems

Answer 2

Joint pain

Joint stiffness

Weakness

Hot/red joints

Loss of function

Question 3

How would you quickly screen the musculoskeletal system

Answer 3

Gait : Observe

Arms:
Elbow & forearm movement
Hand behind head (external rotation)
Inspect hands
Palpate MCPs
Pinch grip

Legs:
Inspect
Passive knee & hip movement
Inspect feet
Palpate MTPs

Spine:
Stand patient
Observe from posterior & lateral
Lateral flexion
Touch toes

Question 4

How should joints be systematically examined?

Answer 4

Look:
general body appearance
compare left and right
Scars/trauma
Vertebral column alignment
Regional deformity and contours
Skin changes (red, bruises, swelling)
Wasting or fasiculations

Feel:
Temperature
Swellings
Tenderness
Lymphadenopathy
Contours of the bones

Move:
Passive and active movements

Question 5

What could cause limited movement at a joint?

Answer 5

Pain

Muscle spasm

Contractures

Inflammation

Swelling

Bony outgrowths

Question 6

DDx of shoulder pain

Answer 6

Rotator cuff tear

Adhesive capsulitis

Biceps tendinitis

Nerve entrampment

Referred pain from gall stones/MI

Infection

Arthritis

Glenoid labrum tear

Question 7

Sprengels shoulder

Answer 7

high riding scapula

Question 8

Scale for assessing muscle power

Answer 8

0 - no visible contraction

1 - visible contraction, no joint movement

2 - moves with gravity

3 - moves against gravity

4 - reduced power against resistance

5 - full power against resistance