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Primer: history and examination in the assessment of musculoskeletal problems


Musculoskeletal problems are very common, and clinical assessment is central to their appropriate management; however, many clinicians are not sufficiently competent to carry out this assessment. A standardized approach to the clinical assessment of a musculoskeletal problem is, therefore, necessary, whether the patient is presenting to primary care, rheumatology or orthopedics. Such a standardized approach gives a benchmark for this competency and can also be used as a teaching aid. As doctors become increasingly competent in clinical assessment and reach into training programs within musculoskeletal specialities, more detailed information will be required from the medical history of the patient, in addition to the use of special tests on clinical examination. These clinical skills need to be taught and also assessed.

Key Points

  • Assessment of the musculoskeletal system should be as thorough as that of other organ systems

  • Assessment of the musculoskeletal system needs to be systematic and sequential; look, feel and move—active and passive

  • Clinical examination of the musculoskeletal system involves many specific tests, but only a limited number needs to be mastered (except by a specialist)

  • A rapid screening assessment should be included in all standard clinical examinations of any patient

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Correspondence to Anthony D Woolf.

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Woolf, A., Åkesson, K. Primer: history and examination in the assessment of musculoskeletal problems. Nat Rev Rheumatol 4, 26–33 (2008).

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