Before proceeding to examination in any joint pathology, it is important to take a good history of the illness. It begins with questions like when did it begin, where is the pain or is there any swelling. History of trauma, tuberculosis, typhoid, exposure to venereal disease is important.
A note about any previous diseases like pneumonia, bacillary dysentery, bleeding tendencies, renal colic. should be made.
Family history of hemophilia, tuberculosis gout, etc should be taken in detail.
Examination
Before you examine joints, one must perform a systemic examination. Joint examination begins by inspection of the joint followed by palpation. Then movements and measurements are tested.
A. Inspection:
- Joints affected
- Position of the joint and fixed deformity
- Swelling
- Signs of inflammation over the joint
- Muscular wasting just above the joint
B. Palpation:
- Local temperature
- Tenderness
- Swelling-fluctuant or non-fluctuant
- Bony components and its relation to the joint
C. Movements
Both active and passive joint movements must be done.
- Pain on movement
- Restriction of movement
- Excessive mobility
- Protective muscular spasms
- Grafting on movement
D. Measurements:
- Length of the limb
- Circumference of the limb
- Relations of various bony points
