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A musculoskeletal exam is the part of a routine physical that assesses the overall function of the muscles and bones. The exam checks a patient’s range of motion, physical strength in different parts of the body, and reflexes. Routine musculoskeletal screenings can help diagnose conditions such as multiple sclerosis and arthritis in their early stages.
There are several types of musculoskeletal exams that may be performed, depending on the patient’s needs. A basic screening exam checks the overall function of a patient without current musculoskeletal complaints. If the patient has symptoms of a disorder, an in-depth exam of the specific region affected is performed. New patients complaining of multiple, widespread musculoskeletal symptoms are typically given an in-depth version of the basic screening exam. Patients undergoing treatment for a diagnosed disorder receive periodic exams pertaining to the specific region affected by the diagnosis.
The basic musculoskeletal exam does not require special equipment, although some doctors may use additional tools to make their task easier. A stethoscope may be used to listen for sounds in the temporomandibular joint (TMJ), as popping and grinding sounds can indicate TMJ disorder. An instrument called a goniometer may be used to measure the angles of the joints.
During a musculoskeletal exam, the doctor begins by visually assessing the range of motion of the joints, both active and passive. The range of motion exam measures a patient’s ability to extend, flex, and rotate the joints in the arms, legs, hands, feet, and hips. Active range of motion refers to a person’s ability to move the joints without assistance. Passive range of motion refers to the range when assisted by another person. The visual exam also looks for signs of redness and swelling around the joints.
Palpation, the part of the musculoskeletal exam in which the doctor exams the patient by touching the muscles and joints using the fingers and thumbs, helps determine if there is any unseen swelling or nodules present. Nodules can indicate the presence of arthritis. Palpation also helps determine if there is pain or tenderness in the joints or surrounding area.
The spine is assessed using percussion, a method in which the physician taps parts of the body, either with his hands or a special instrument. The sounds made during percussion can provide the physician with information about the size of the organ and alert him to the presence of fluid buildup. The physician also notes the curvature of the spine, and the symmetry of the shoulders.
If any abnormalities are found during a musculoskeletal exam, additional tests are typically ordered to confirm a diagnosis. The exam itself is a useful tool in discovering potential issues, but cannot be used to conclusively diagnose conditions on its own. Prior to a musculoskeletal exam, patients should inform their physician if they have been suffering from any pain, swelling, or tenderness, and whether any recent activities could have contributed to those symptoms.