Routine Ax/Observations

Question 1

What can be done in a routine MSK objective assessment and what do they each test?

Answer 1

Observation - Colour, atrophy, alignment, swelling, deformity

Palpation - Temperature, swelling, atrophy

Effusion - sweep test (patella)

AROM and PROM - differential diagnosis

Resisted testing - differential diagnosis (muscle strength/weakness)

Accessory - tests joints

Ligaments - test ligaments

Functional tests - balance, proprioception, strength (sit to stand, reach, walking, hopping, squats)

Palpation (again) - confirm painful structure

Question 2

What would you look for in alignment for observations?

Answer 2

Limb position (symmetry)

Plumb lines (valgus/varus)

Check bony points (dislocation and fractures)

Shape and deformity

Question 3

What would you look for in colour for observations?

Answer 3

Bruising/haematoma (sprain/strains/fractures)

Necrosis (black or grey tissue - check pulses)

Cyanosis/poor circulation

Cellulitis (skin inflammation - can use pen to mark the most distal part to see if it spreads, can lead to sepsis if not treated)

Question 4

What would you look for in atrophy for observations?

Answer 4

Muscle wastage (size)

The site of atrophy (compartment syndrome, neural issues - sciatica, viruses).

Question 5

What would you look for in deformity in observations?

Answer 5

Dislocation/Fractures

Bony lumps

Lack of symmetry