A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further:
- Inspection (viewing).
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation (palpation) of the painful area [pressure pain, pain on movement, pain at rest?]
- Palpation of the abdomen (belly), etc.
- Checking the mobility of the painful area [functional limitation?]
- If necessary, orthopedic examination [due todifferential diagnoses:
- Fibrodysplasia ossificans progressiva (FOP; synonyms: Fibrodysplasia ossificans multiplex progressiva, Myositis ossificans progressiva, Münchmeyer syndrome) – genetic disease with autosomal dominant inheritance; describes pathological, progressive ossification (ossification) of the connective and supporting tissues of the human body, leading to ossification of the musculature; shortened and twisted big toes are already present at birth as a nonspecific symptom.
- Bone abscess
- Paget’s disease (osteodystrophia deformans) – bone disease that results in bone remodeling and gradual thickening of several bones, usually the spine, pelvis, extremities or skull.
- Ossification (ossification) after fractures (bone fractures).
- Osteochondrosis dissecans – circumscribed aseptic bone necrosis below the articular cartilage, which can end with the rejection of the affected bone area with the overlying cartilage as a free joint body (joint mouse).
- Osteomyelitis – acute or chronic inflammation of the bone and bone marrow, usually due to bacterial infection; combination of osteitis and myelitis (bone marrow/spinal cord).
- Osteopoikilosis (synonyms: osteopathia condensans disseminata, osteopoikilia; “stippled bone”) – multiple, small, round or oval foci of bony sclerosis (“hardening”; localized in the metaphyseal-epiphyseal region of long bones, among others; may simulate osteoblastic bone metastases in breast carcinoma
- Ostitis (synonym: osteitis) – inflammation of bone tissue.
- Injuries/sports injuries]
[due topossible secondary diseases:
- Chronic pain
- Pathological fracture (bone fracture) (spontaneous fracture due to pathological (pathological) processes in the bone)]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.