Clinical Examination

in
Orthopaedics
Dr N Purushothama Rao,
MB, MS Orth, MCh Orth, MRCS Ed. MRCS
Glas.

 As in other fields of medicine& surgery, diagnosis of

orthopaedic disorders depends first upon an accurate
determination of all the abnormal features from:
1. the history
2. clinical examination
3. radiographic exam n other imaging
4. special investigations.
Secondly, it depends upon a correct interpretation of
the findings.

Some examples of Good

History
A teenager fell while
skating, brought with a
swollen painful n slightly
bent left knee which
appeared sooner after the
fall
X rays- ? cannt find
anything

 With in 1st 3 months of my busy SHO job in Scotland

Called to A & E to see a middle aged woman with
LBA, cud hardly take any Hx n Briefly had look at
her before rushing to my Day surgery unit
After 5pm A& E told me pt got admitted to OBG
bec of abd swelling
After 6 PM I was not still settled reg this
Went to her in OBG ward

 A teenager been referred to Orth

Surgeon in US labelled w diagnosis of
Osteosarcoma
Hx- an active sports playing School boy
with Pain in Right Thigh initially
presented to his GP, who ordered an
MRI which is reported as Osteosarcoma
hence the referral to Specialist

? Cx Spondylitis
An elderly woman got admitted to
Orth ward over night with weakness
in the Right UL of recent onset
She has already been seen in the OPD
and MRI of C spine been requested a
few wks ago, still awaiting.
That morning got her MRI of C spine
which is nearly normal

? Spinal injury