Examination for PMR
Back to Hip and shoulder pain in older adults – PMR
A physical examination is essential – patients expect it, and it can provide important information about the problem.
The first aim of examination should be to establish whether the pain is coming from the joint or surrounding tissues. Articular problems are usually characterised by tenderness along the joint line and/or pain at the end of the range of movement, with any restriction in range of movement tending to be equal in both active and passive movement.
Suggested examination technique
Musculoskeletal screening examination, e.g. GALS screen To quickly and systematically screen for normal and abnormal joints
Examine joints reported as painful To look for specific abnormalities such as swelling, redness, heat, bruising, deformity, loss of range of movement, pain on movement
and ability to form a complete fist (ability to completely cover fingernails in fist position) to test for possible inflammatory arthritis MTPJ/MCPJ squeeze test To determine subtle synovitis from inflammatory arthritis
Examine for finger/toenail abnormalities, skin rashes, psoriasis, alopecia, petechiae To look for signs of inflammatory arthritis, connective tissue diseases or other systemic illness
Examine any other systems identified in history To look for systemic illness or rheumatological presentations of systemic disease
Neurological examination, particularly looking for weakness or upper motor-neurone signs To look for rheumatological presentations of neurological disease
Palpate for lymphadenopathy, take temperature To look for systemic illness or rheumatological presentations of systemic disease
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GALs screen and examining for swelling. Back to Hip and shoulder pain in older adults – PMR