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, gentle posture).
- Malpositions (deformities, contractures, shortenings).
- Muscle atrophies (side comparison!, if necessary circumference measurements).
- Joint (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); injury indications such as hematoma formation, arthritic joint lumpiness, leg axis assessment).
- Palpation (palpation) of prominent bone points, tendons, ligaments; musculature; joint (joint effusion?); soft tissue swelling; [tenderness (localization!); limitation of movement].
- Measurement of joint mobility and range of motion of the joint (according to the neutral zero method: the range of motion is given as the maximum deflection of the joint from the neutral position in angular degrees, where the neutral position is designated as 0°. The starting position is the “neutral position”: the person stands upright with the arms hanging down and relaxed, the thumbs pointing forward and the feet parallel. The adjacent angles are defined as the zero position. Standard is that the value away from the body is given first). Comparative measurements with the contralateral joint (side comparison) can reveal even small lateral differences.
- If necessary, special functional tests depending on the affected joint:
- Finkelstein test: during jerky passive ulnar abduction (lateral displacement (abduction) of the hand or fingers in the direction of the ulna (ulna)) with the thumb flexed and the fist closed, pain occurs in the first extensor tendon compartment. This results in constriction of the tendon of the extensor pollicis brevis muscle (Latin for “short thumb extensor”) and thus pain over the styloid process (stylar process of the radius). A positive test result is pathognomonic (disease characteristic) for tendovaginitis stenosans de Quervain.
- Inspection (viewing).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
