A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin, mucous membranes, and sclerae (white part of the eye) [subcutaneous nodules, palpable purpura (small-spotted capillary hemorrhages in the skin, subcutis, or mucous membranes (cutaneous hemorrhage)), possibly necrosis; lower extremities often affected]
- Gait pattern [myalgias (muscle pain) and arthralgias (joint pain)]
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Palpation of vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral musculature); soft tissue swelling; tenderness (localization! ; restricted mobility (spinal movement restrictions); “tapping signs” (testing 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?
- Palpation of prominent bone points, tendons, ligaments; musculature; joint (joint effusion?); soft tissue swelling; tenderness (localization!).
- Inspection (viewing).
- Ophthalmological examination – for red eye, etc.
- ENT medical examination – for sinusitis.
- Neurological examination – in case of polyneuritis (inflammation of nerves).
Square brackets [ ] indicate possible pathological (pathological) physical findings.
