Orthopaedics  |  History and Examination




Orthopaedics

History and Examination

Take a history, including:

  • duration of symptoms
  • severity/character of symptoms
  • severity
  • when symptoms occur, eg night-time
  • type of symptoms:
  • tingling
  • burning
  • aching
  • if symptoms are intermittent or persistent
  • activities that improve, or exacerbate, symptoms
  • location/radiation:
  • location of the pain/numbness - are symptoms in the median nerve distribution of the hand?
  • consider using a hand diagram to see if symptoms localise to the median nerve distribution
  • if symptoms radiate to a specific area of the body
  • any other associated symptoms
  • progression
  • symptoms are improving, deteriorating or stable
  • rate of any changes
  • previous treatment
  • what has been tried
  • what the results were
  • lifestyle and activities
  • Perform a physical examination that may include:

Personal characteristics:

  • age
  • gender
  • weight
  • height
  • range of motion of the hand and wrist
  • observation of hand, wrist, and forearm:
  • deformity
  • swelling
  • atrophy
  • skin trophic changes
  • pinch/grip strength
  • hand diagram
  • sensory examination, eg:
  • two-point discrimination
  • Semmes-Weinstein monofilament
  • vibrometry
  • texture discrimination
  • manual muscle testing of the upper extremity, eg thenar muscle atrophy
  • provocative tests, eg:
  • Phalen's test
  • Tinel's sign
  • median nerve compression test
  • reverse Phalen's test
  • discriminatory examination for alternative diagnoses, eg:
  • radiculopathy
  • neuropathy
  • pain syndromes
  • arthritis
  • tendonitis
  • vascular abnormalities

 



Last updated : Tuesday, October 13, 2015
Next review date : Wednesday, October 12,2016


Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.