Examination
Look
- Walking Aids:
- Observe for the use of crutches, braces, or other aids.
- Muscle Wasting:
- Global wasting, with particular attention to the Quadriceps.
- Limb Length Discrepancy:
- Assess for differences in leg length.
- Flexion Deformity of Knee:
- Check for over-pulling by hamstrings.
- Foot Deformities:
- Note any type of deformity (e.g., pes cavus or claw toes).
- Scars:
- Inspect hips, knees, and feet for surgical or traumatic scars.
- Spine:
- Gait:
- Look for:
- Asymmetric gait.
- Reduced cadence.
- Changes in foot progression angle.
- Trendelenberg gait (indicating abductor weakness).
- Quadriceps-deficient gait (knee hyperextension during stance phase).
- Foot drop.
- Compensatory movements at the pelvis, hip, knee, and ankle.
Feel (Lying Down)
- Pain:
- Assess for tenderness or discomfort in affected areas.
- Sensory Examination:
- Test dermatomes and peripheral nerves; sensory function is typically intact.
- Motor Power:
- Assess strength in myotomes and peripheral nerves.
- Upper Motor Neuron (UMN) Signs:
- Check for Clonus, Babinski sign, and altered reflexes.
Move (Lying Down)
- Range of Motion (ROM):
- Evaluate ROM in all joints.
- Hip Dislocation:
- Screen for any signs of dislocation.
- Correctibility of Deformities:
- Test whether deformities can be corrected manually.
Finishing Steps
- Take a full history.
- Document findings systematically.
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