A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
- Inspection (viewing).
- Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes [redness of skin and increased venous markings].
- Gait pattern (fluid, limping).
- Body or joint posture (upright, bent, gentle posture).
- Malpositions (deformities, contractures, shortenings).
- Muscle atrophies (side comparison!, if necessary circumference measurements).
- Joint (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); injury indications such as hematoma formation, arthritic joint lumpiness, leg axis assessment) [swelling in the affected region/strong pressure sensitivity; with joint involvement forced posture, painful functional lock; possibly also effusion and compression pain].
- Palpation (palpation) of vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral muscles); soft tissue swelling; tenderness (localization! ); restricted mobility (spinal movement restrictions); “tapping signs” (testing for painfulness of spinous processes, transverse processes, and costotransverse joints (vertebral-rib joints) and back muscles); illiosacral joints (sacroiliac joint) (pressure and tapping pain?; compression pain, anterior, lateral, or saggital); hyper- or hypomobility? [pain in affected region; swelling in affected region].
- Palpation of prominent bone points, tendons, ligaments; musculature; joint (joint effusion?); soft tissue swelling; pressure pain (localization!) [swelling in the affected region/strong pressure sensitivity; with joint involvement forced posture, painful functional lock; possibly also effusion and compression pain].
- Assessment of blood flow, motor function, and sensitivity:
- Circulation (palpation of pulses).
- Motor function: testing of gross strength in a lateral comparison.
- Sensibility (neurological examination)
- Inspection (viewing).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.