The Orthopaedic Physical Examination

Matthew A. Varacallo, MD

Jonathan R. Kaplan, MD, FAAOS

Dr. Varacallo or an immediate family member serves as a paid consultant to or is an employee of Arthrex, Inc. Dr. Kaplan or an immediate family member has received royalties from Novastep; serves as a paid consultant to or is an employee of Medline, Novastep, and Vilex; has stock or stock options held in GLW Medical Innovation; and serves as a board member, owner, officer, or committee member of American Orthopaedic Foot and Ankle Society.

Introduction

Although the orthopaedic examination will be covered in depth in each chapter as it pertains specifically to the key components of a particular topic or body part, this chapter will present the general approach to the orthopaedic evaluation.

The orthopaedic evaluation is a systematic process that examination should follow in a clear, concise, and reproducible pattern to ensure both efficiency and accuracy. In addition to a thorough history, the orthopaedic examination is critical to aid in the evaluation, diagnosis, and treatment of the patient.

Inspection and Observation

Findings can dictate perspective for the remainder of the physical examination
Assessment of patient in clinical setting
- Reasonable distance given setting (office, trauma bay, etc)
- Multiple views/angles for comprehensive assessment
Gait pattern (if applicable)
Region/extremity soft-tissue integrity (open wounds, obvious deformity)
Limb and joint alignment
Skin assessment
- Edema, swelling
- Ecchymosis
- Discoloration (dusky, pale, etc)
- Abrasions
- Open wounds, lacerations
- Compartment swelling/pressure (firm, compressible, etc)