A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination-including blood pressure, pulse, body temperature, body weight, height [overweight (obesity)]; furthermore:
- Inspection (viewing).
- Skin and mucous membranes; due tohyperuricemia (gout):
- Acute gout: podagra – severe joint pain in the metatarsophalangeal joint of the big toe; other joints frequently affected are the knee and ankle joints, reddened, overheated
- Chronic gout: tophi – gouty nodules made of uric acid crystals – in joints and soft tissues; predilection sites are: Ear cartilage (helix of the auricles, so-called gout pearls), eyelids, nostrils, bursa, extensor sides of the elbow joints; joint deformities.
- Joint (abrasions/sores, swelling (tumor), redness (rubor), hyperthermia (calor); injury indications such as hematoma formation, arthritic joint lumpiness) [monoarticular joint pain: joint is swollen, red].
- Skin and mucous membranes; due tohyperuricemia (gout):
- Palpation (palpation) of joint [overheated and tender to pressure/extreme painfulness; palpate extremities – hands, feet, olecranon, knee joints – for soft tissue and bone tophi].
- Palpation of the abdomen (abdomen) [hepatomegaly (enlargement of the liver) due to chronic alcohol consumption; possibly steatosis hepatis (fatty liver), cirrhosis of the liver; abdominal tenderness in chronic pancreatitis (inflammation of the pancreas)]
- Inspection (viewing).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.