Testing muscle and joint function plays a major role in orthopedics. For this purpose, range of motion, muscle tension, and strength are assessed. The spine and trunk, shoulder, elbow, hand and fingers, elbow, hip, knee and feet are examined. Numerous different tests exist and the examiner will not perform all nearly 50 for the knee joint, 60 for the spine or 40 for the shoulder each time, but will selectively choose those that help with his suspected diagnosis. To do this, the doctor bends, stretches and moves these joints in several directions on the relaxed patient and presses at various points. In addition, the patient must move actively (e.g., bending forward to evaluate spinal mobility) and tense muscles in different areas of the body against the examiner’s resistance.
Imaging and other procedures
Bones can be visualized particularly well by classic radiographic examinations. For example, bone fractures, spinal changes, and inflammatory lesions are revealed. More precise details, especially of the intervertebral disc, are provided by computed tomography (CT). Muscles and soft tissues as well as joints, on the other hand, can be well assessed with ultrasound and thus, for example, bursitis, joint effusions and muscle injuries can be detected. Also the
magnetic resonance imaging is also suitable for assessing bones, joints, soft tissues and intervertebral discs. It provides a particularly good insight into the bone marrow and – since it does not involve radiation exposure – is especially well suited for children and adolescents. In osteodensitometry
Osteodensitometry measures bone density. It is therefore used primarily in cases of suspected osteoporosis. Inflammations and tumors can be detected earlier with skeletal scintigraphy than with conventional X-rays. In addition, all bones can be examined at once. To do this, a radioactively labeled substance is injected and a special camera is used to observe how it is absorbed into the bones: the greater the blood flow (e.g., in a tumor), the higher the accumulation. To be able to look directly into the joint, take a tissue sample and, if necessary, take therapeutic action, arthroscopy is suitable.
