Following a routine exam to assess your overall health (taking your blood pressure, listening to your heart), the doctor will focus on the joints that are bothering you — feeling and pressing on them for signs of swelling or tenderness and watching how they “work” when you walk or bend. The doctor will also assess other joints, which could be affected by arthritis even though you don’t know it yet.
During the joint examination, the doctor will ask you to move joints (“active motion”) and will also move them himself (“passive motion”). In true joint disease, movement is limited and causes pain with both active and passive motion. If the doctor can move a joint further than you can (flex your knee in a wider arc, for example), then you probably don’t have a problem with your joint but instead with the tendons or muscles surrounding it.
Different joints are examined in different ways:
The doctor checks for bony enlargements on the end joints of fingers or on the middle joints. These outgrowths, or nodes, are clear signs of osteoarthritis.
Limited range of motion is the key indicator. With the patient lying on his back with knees bent, the doctor places one hand on the knee and the other on the heel and then rotates the foot outward and inward. Restricted inward rotation is typically an early sign of hip osteoarthritis.
In addition to checking for abnormalities in joint movement, the doctor looks for areas of swelling around the knee joint.
The doctor palpates (feels) the contours of the spine to check for abnormal tenderness and assesses range of motion — whether the patient can touch his ear with his shoulder, for example.
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