Skip to Main Content

LEARNING OBJECTIVES

LEARNING OBJECTIVES

  1. Identify the purposes of performing a musculoskeletal examination.

  2. Discuss the components of a musculoskeletal examination.

  3. Identify questions that should be included in a patient interview.

  4. Describe the procedures used to selectively test specific tissue types in a musculoskeletal examination.

  5. Identify additional procedures that often complement a musculoskeletal examination.

  6. Using the case study examples, apply clinical decision making skills in evaluating musculoskeletal examination data.

INTRODUCTION

The musculoskeletal system includes bones; muscles with their related tendons and synovial sheaths; bursa; and joint structures such as cartilage, menisci, capsules, and ligaments. Acute injuries or chronic conditions of the musculoskeletal system can greatly affect function by causing direct impairments such as pain, inflammation, swelling, structural deformity, restricted joint movement, joint instability, and muscle weakness. Examples of diagnoses that result in direct impairment of the musculoskeletal system include fracture, rheumatoid arthritis (RA) and other systemic diseases, osteoarthritis, (OA), joint dislocation, tendinitis, bursitis, muscle strain/rupture, and ligament sprain/rupture. Importantly, musculoskeletal disorders are the second most common cause of disability worldwide, measured by years lived with disability, with low back pain being the most frequent condition.1 In addition to primary musculoskeletal impairments, many pathological conditions that initially affect other body systems such as the neurological, cardiovascular, or pulmonary systems, can result in secondary or indirect impairment of the musculoskeletal system. Both direct and indirect musculoskeletal impairments can contribute to activity limitations, participation restrictions, and disability that affect a patient’s ability to perform certain tasks and roles in society. Thus, performing a systematic, evidence-based, and thorough evaluation is an important skill for health care professionals who encounter patients with musculoskeletal disorders (e.g., physical therapists, athletic trainers, general practitioners, orthopedic surgeons), as it will form the foundation for an effective treatment plan. In addition to clinical competence, the clinician should demonstrate respect, interest, and empathy toward patients, who frequently feel vulnerable and lost within the health care system.

This chapter discusses the purposes of, and provides a general framework for, conducting a musculoskeletal examination. Other resources are available that provide detailed musculoskeletal testing procedures of specific body regions.2-4

PURPOSES OF THE MUSCULOSKELETAL EXAMINATION

Evaluation of data from the musculoskeletal examination contributes to establishing a diagnosis and prognosis, setting anticipated goals and expected outcomes, and developing and implementing a plan of care (POC). A musculoskeletal examination is also an important component of evaluating treatment outcomes both periodically during the treatment process and at the conclusion of the episode of care. The purposes of performing a musculoskeletal examination include the following:

  1. To determine the presence and extent of impairments, activity limitations, and disability involving muscles, bones, and related joint structures.

  2. To identify the specific tissues and pathology causing/contributing to the impairment, activity limitation, or disability when possible.

  3. To establish objective baseline status that will be used to measure progress.

  4. To formulate appropriate goals, expected outcomes, and plan of ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.