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 (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes.
- Gait (fluid, limping).
- Body or joint posture (upright, bent, relieving posture).
- Initial stage [postural weakness; hollow back].
- Florid stage [fixed thoracic kyphosis (fixed hunchback), to compensate for this, the lumbar spine (LS) often also curves forward at the same time, creating the image of a hollow hunchback; increase in kyphosis and fixation district]
- Late stage [fixed kyphosis; ventral displacement (forward shift) of the center of gravity of the torso]
- Malpositions [deformities, contractures, shortenings].
- Muscle atrophies (side comparison!, if necessary circumference measurements).
- Palpation (palpation) of the vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral muscles); soft tissue swelling; tenderness (localization! ); restricted mobility (spinal movement restrictions); “tapping signs” (test for 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? [Pain-related limitation of spinal movement [late stage: osteochondrotic changes (spondylosis/degenerative changes in vertebral bodies, spondyloarthritis/degenerative disease of the spine)]].
- Inspection (viewing).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
