Musculoskeletal system diseases and knee evaluation are among the most common reasons for visiting a doctor, ranking second after hypertension. In recent years, great progress has been made in diagnosing and treating musculoskeletal system diseases.
Despite the emergence of new, highly informative methods of laboratory and instrumental research, the clinical examination of the musculoskeletal system remains relevant in the diagnosis of joint diseases.
Insufficient knowledge of methods of clinical examination of the musculoskeletal system by doctors can be the reason for late diagnosis of the disease, leading to high economic costs for expensive, sometimes unnecessary examinations of patients.
In this regard, a rational approach to diagnosing diseases of the musculoskeletal system with the determination of the location of the affected structure and the nature of the lesion already at the stage of clinical examination is relevant.
This requires the doctor to know the musculoskeletal system’s anatomy well and be proficient in clinical methods for examining the joints, including examination, palpation, and special tests. Having the skills of a clinical examination of the musculoskeletal system, the doctor can solve the issues of diagnosis and differential diagnosis of joint diseases.
Palpation, conducting special tests. Having the skills of a clinical examination of the musculoskeletal system, the doctor can solve the issues of diagnosis and differential diagnosis of joint diseases. Palpation, conducting special tests. Having the skills of a clinical examination of the musculoskeletal system, the doctor can solve the issues of diagnosis and differential diagnosis of joint diseases.
Screening knee Evaluation system should be included in the general medical examination of the patient. It is well known that various internal organs and systems are affected by many rheumatic diseases. Damage to the musculoskeletal system is often observed in diseases of other organs and systems [2, 3].
The cause of joint pain may be damage to neighboring anatomical structures or diseases of internal organs. In these cases, the use of special clinical tests helps to clarify the localization of the lesion, determine the cause of the pain syndrome and help to conduct a differential diagnosis.
Clinical examination of the musculoskeletal system in patients with rheumatic diseases includes history taking, examination, palpation, examination of joint mobility, joint function,
The hip joint is the largest in the human body. It plays a major role in maintaining posture, body weight, and locomotion. The defeat of this joint leads to rapid disability not only in elderly patients but also in young people.
Performing Specific Clinical Tests
In this short article, we present only a few specific tests to assist in diagnosing hip disorders.
A quadrant test is used to diagnose hip joint damage. It is carried out as follows: the patient lies on his back, and the doctor flexes the hip and knee joints of the limb under study and directs it to the opposite shoulder.
The clinician then moves the hip into abduction while maintaining flexion at the hip joint. The appearance of crepitus or shock felt by the doctor indicates the presence of pathology of the hip joint and knee evaluation.
The defeat of the hip joint is characterized by the early development of weakness of the abductor muscles of the thigh (middle and small gluteal). To diagnose this condition, the patient is asked to alternately raise both legs.
With the weakness of the abductor muscles of the thigh on the loaded side, the pelvis tilts, and the patient loses balance and cannot keep the healthy leg on weight (Trendelenburg’s symptom).
In some patients, the development of compensatory lumbar lordosis masks the presence of flexion contracture of the hip joint, which is most common in primary and secondary osteoarthritis. Its identification is facilitated by the Thomas test, which is carried out in the patient’s horizontal position.
The patient is asked to perform flexion in the knee and hip joints of the healthy side, gradually bringing the leg closer to the chest. If the hip flexion angle increases, the opposite hip joint also begins to bend, indicating the presence of a flexion contracture of this joint.
The inability to firmly press the lumbar spine to the flat surface of the couch may also indicate the flexion contracture of the hip joint.
The differential diagnosis between joint damage and damage to periarticular tissues is facilitated by studying resistive active (isometric) movements.
They are based on the patient performing movements with overcoming the doctor’s resistance. The appearance and intensification of pain and weakness during these movements indicate damage to the periarticular structures or peripheral nerves.
Thus, the appearance or intensification of pain in the inguinal region with resistive active adduction of the hip joint and Knee Evaluation indicates the presence of adductor muscle enthesopathy.
The appearance or intensification of pain in the region of the greater trochanter of the femur with resistive active abduction indicates the presence of abductor muscle enthesopathy.
Thus, a thorough, targeted clinical examination helps the clinician diagnose damage to the hip joint and Knee Evaluation periarticular structures. Choose the necessary laboratory and instrumental research methods, as indicated in this case.
