Musculoskeletal Disorders: History Taking, Physical Examination, Investigations and Diagnosis

Abstract

The aim of present study was to learn about the common musculoskeletal disorders. Proper history taking and thorough examination of each limb and joint systematically is the key to management of musculoskeletal disorders. Musculoskeletal disorders generally present with pain, dysfunction and deformity. Onset of symptoms should be ascertained whether they are acute or chronic. The natural history of the problem also gives clue to diagnosis and the type of pain is important for diagnosis of origin of pain. History of comorbidities and past surgery is important and should be documented. Inspection of skin, soft tissue and bones should be carried out. A thorough general examination of skin should include a look out for scars, loss of sweating, redness, bruising and wounds. Soft tissues should be inspected for swelling and wasting and bones should be inspected for deformity. Palpation should be carried out in a systematic manner and the skin should be felt for temperature and sensation. Soft tissues should be palpated for lumps, tenderness and circulation whilst bones should be palpated for bone outlines and joint margins. Active and passive movements at various joints should be tested. Power of various muscles should be tested and graded as per the Medical Research Council (MRC) Muscle power scale. The gait of the patient should be observed to see if there is a limp.

Keywords: Musculoskeletal disorders, limb, joint, pain, dysfunction