Joint Pain (Arthralgia): Examination

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).
      • 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].
    • Palpation (palpation) of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; tenderness (localization!).
    • Measurement of joint mobility and range of motion of the affected joint(s) (according to the neutral zero method: range of motion is given as the maximum deflection of the joint from the neutral position in angular degrees, with the neutral position designated as 0°. The starting position is the “neutral position”: the person stands upright with the arms hanging down and relaxed, the thumbs pointing forward and the feet parallel. The adjacent angles are defined as the zero position. Standard is that the value away from the body is given first).
      • Onset pain: onset pain is expressed at the onset of activity in a joint. Start-up pain is typical of joint changes caused by degenerative conditions
      • Night pain or pain at rest: night pain occurs at rest, so this pain is often perceived at night. Night pain or pain at rest is mainly found in inflammatory diseases of the joints. In degeneratively altered joints rest pain often occurs after overload.
      • Strain pain: the strain pain is to be triggered only when the joint is loaded. At rest, it disappears. A strain pain can occur, among other things, in traumatic lesions (injuries) of a joint. Furthermore, a strain pain can be expressed in inflammatory or degenerative changes.
    • Assessment of blood flow, motor function and sensitivity:
      • Circulation (palpation of pulses).
      • Motor function: testing of gross strength in lateral comparison.
      • Sensibility (neurological examination)
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.