Physical Examination of Arthritis

Lee, Sung Won

Abstract

The goal of physical examination is to establish the diagnosis and to evaluate status of the disease after treatment. Physical examination of arthritis also is the most important skill with history taking for the diagnosis and evaluation in patients with rheumatic diseases. In general physical examination is composed of inspection, auscultation, percussion, and palpation, but in patients with arthritis it means mainly inspection and palpation. Inspection consists of visual examination including gait, the shape of the joints, deformities, symmetries, swelling, erythema, atrophy of muscle, ability to move the joint, and skin change over the affected joint as well as other areas. Palpation is to feel warmth, tenderness, and swelling, to touch the margin of each joint, and to confirm range of motion. To establish the anatomical source of pain requires differentiating between articular versus extra-articular source. An expertise in physical examination requires knowledge in anatomy, skill, and special test and physicians have to become familiar with physical examination through repeated training from patients with similar musculoskeletal problems.