A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing).
- Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes.
- Gait (fluid, limping).
- Body or joint posture (upright, bent, gentle posture; asymmetries? (pelvic obliquity (= leg length difference < 2 cm), scoliosis); increased or decreased thoracic kyphosis?, lumbar lordosis?)
- Malpositions (deformities, contractures, shortenings).
- Muscle atrophies (side comparison!, if necessary circumference measurements).
- Palpation (palpation) of the vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral muscles); soft tissue swelling; tenderness (localization! ); limited mobility (spinal motion 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?
- Orthopedic examination – including testing of range of motion.
- Neurological examination – including testing of reflexes, motor function and sensitivity.
- Health check
