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