EXAMINATION OF SHOULDER JOINT
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HISTORY
Pain
Swelling
Deformity
Loss of contour
Restrictions &
Loss of
Movements
INSPECTION (sitting position)
• Attitude
• Wasting of supra- & infraspinatus
muscles
• Wasting of deltoid & rotator cuff
muscles
From
• Prominence of
Front
o Sternoclavicular joint
o Deformity of clavicle
o Acromioclavicular joint
o Wasting od deltoid muscle
From
• Position of scapula
Behind • Supra- & infraspinatus
wasting
From
• Asymmetry of supraclavicular
Above
fossae
From
• Swelling
Sides
• Flattening/Rounded fullness
of joints
PALPATION
• Local temperature
• Tenderness
o Below acromion
o Below acromion
and arm
o Along coracoid
process
o Posteriorly
o All around joint
• Swelling
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MOVEMENTS
Flexion (180°)
Extension (45°)
Abduction (180°)
Adduction
Int rotation (80°)
Ext rotation (50-90°)
MEASUREMENTS
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TESTS
Apprehension
test
Bryant’s sign
Callaway’s
test
Duga’s test
Hamilton’s
test
Painful arc
test
OTHER EXAM.
• Cervical spine
• Acromioclavicular
& sternoclavicular
joints
• Neurovascular
examination of UL
• Systemic (Tb, RA
etc.)
EXAMINATION OF ELBOW JOINT
HISTORY
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Pain
Trauma
Stiffness
Loss of
Movements
• Deformity
INSPECTION (standing position)
• Attitude
• Carrying angle (M:10°, F:15-20°)
• Anterior, posterior, medial & lateral
surface:
o Deformity
o Swelling
o Soft tissue & skin
o Muscle wasting of forearm & arm
muscles
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PALPATION
(sitting/supine)
Local temperature
Tenderness over:
o Lateral epicondyle
o Medial epicondyle
o Olecranon process
o Cubital fossae
o Radial head
Bony landmarks:
o Lateral epicondyle
o Medial epicondyle
o Olecranon process
Swelling
Bony thickening:
o Lower end of
humerus
o Upper end of
radius & ulnar
Lymph nodes:
o Supratrochlear
o Axillary
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MOVEMENTS
MEASUREMENTS
Flexion (0-140°)
Extension (0°)
Supination (75-80°)
Pronation (85°)
• Arm length
(from angle of
acromion to
lateral
epicondyle)
• Forearm length
(lateral
epicondyle to
radial styloid
process)
• Estimate
deformity &
muscle wasting
TESTS
• Cozen’s test
(for lateral
epicondylitis
@ tennis
elbow)
• Reverse
Cozen’s test
(for Golfer’s
elbow)
OTHER EXAM.
• Shouder joint, neck
& wrist joint
• Systemic (Tb, RA
etc.)
EXAMINATION OF WRIST JOINT
HISTORY
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•
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Trauma
Pain
Swelling
Deformity
Restrictions &
Loss of
Movements
INSPECTION
(sitting/supine)
• Entire forearm, wrist,
hand
• Attitude
• Dorsal, radial, ulnar,
volar surface:
o Deformity
o Swelling
o Scars & sinuses
o Muscle wasting
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PALPATION
(sitting/supine)
Local temperature
Tenderness
o Wrist joint line
o Anatomical snuffbox
o Lateral surface
Swelling
Deformity
MOVEMENTS
• Palmarflexion (80°)
(Reverse Indian
salutation method)
• Dorsiflexion (70°)
(Indian salutation
method)
• Radial deviation (20°)
• Ulnar deviation (30°)
• Pronation
• Supination
MEASUREMENTS
• Length of:
o Forearm
o Arm
• Girth of forearm
TESTS
OTHER EXAM.
• Finkelstein’s test
• Neurovascular
(Quervain’s disease)
examination of UL
• Finsterer’s sign
• Systemic (Tb, RA
(Kienbock’s disease)
etc.)
• Maisonneuve’s sign
(old malunited Colle’s fx)
• Phalen’s sign
(carpal tunnel synd)
• Carpal lift test
(carpal bones fx)
• Bracelet test (RA)
• Bunnel test
(OA of DCP joint)
• Allen’s test (entrapment
of vessel at wrist)