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 and mucous membranes [systemic lupus erythematosus: butterfly-shaped erythema (butterfly erythema) on the face (nasal and cheek areas), in 80% of affected persons, ulcers on the oral mucosa; plaque-type psoriasis – persistent, slow-growing plaques; corresponds to psoriasis vulgaris type I, nail psoriasis; Lyme disease: erythema migrans]
- Gait pattern (fluid, limping) [polymyositis: proximal muscle weakness]
- Body or joint posture (erect, flexed, relieving posture).
- Joints (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); movement restriction passive and active, capsular pattern?, instability?, injury indications such as hematoma formation, arthritic joint lumpiness; symmetry/asymmetry?)
- Palpation (palpation) of joints [overheated?, tender to pressure?, soft tissue and bone entophi? (due togout); symmetrical (bilateral) appearance? (due torheumatoid arthritis)]
- 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 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?
- Inspection (viewing).
- Ophthalmologic examination [ocular inflammation? (due toreactive arthritis (post-infectious arthritis)/Reiter’s disease)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.