Musculoskeletal

Musculoskeletal Examination (Joint-by-Joint with Special Tests)

Neck (Cervical Spine)

• Inspection: No deformities, asymmetry, or muscle atrophy
• ROM: Flexion, extension, lateral flexion, rotation
• Palpation: No tenderness over spinous processes or paraspinal muscles
• Strength: C1-T1 myotomes intact
• Reflexes: Biceps (C5), Brachioradialis (C6), Triceps (C7)
• Special Tests:
  • Spurling’s Test – Cervical radiculopathy
  • Distraction Test – Nerve root involvement
  • Lhermitte’s Sign – Cervical myelopathy
  • Hoffmann’s Reflex – Upper motor neuron lesion

Thoracic Spine

• Inspection: No scoliosis, kyphosis, or deformities
• ROM: Flexion, extension, rotation, lateral flexion
• Palpation: No tenderness over vertebrae, ribs, or costovertebral joints
• Special Tests:
  • Adam’s Forward Bend Test – Scoliosis
  • Chest Expansion Test – Ankylosing spondylitis

Lumbar Spine

• Inspection: No deformities, step-offs, muscle atrophy
• ROM: Flexion, extension, lateral flexion, rotation
• Palpation: No tenderness over spinous processes, paraspinal muscles, or sacroiliac joints
• Strength: L2-S1 myotomes intact
• Reflexes: Patellar (L4), Achilles (S1)
• Special Tests:
  • Straight Leg Raise – Lumbar radiculopathy
  • Slump Test – Sciatic nerve involvement
  • Patrick’s (FABER) Test – SI joint dysfunction
  • Gaenslen’s Test – SI joint pathology

Shoulder

• Inspection: No deformity, muscle atrophy, scapular winging
• ROM: Flexion, extension, abduction, adduction, internal/external rotation
• Strength: Deltoid, supraspinatus, infraspinatus, subscapularis
• Special Tests:
  • Neer’s Test, Hawkins-Kennedy Test – Impingement
  • Empty Can Test, Drop Arm Test – Rotator cuff tear
  • Speed’s Test, Yergason’s Test – Biceps tendinopathy
  • Apprehension & Relocation Tests – Instability

Elbow

• ROM: Flexion, extension, supination, pronation
• Special Tests:
  • Cozen’s, Mill’s, Maudsley’s Tests – Lateral epicondylitis
  • Tinel’s Sign – Ulnar nerve entrapment

Wrist & Hand

• ROM: Flexion, extension, radial/ulnar deviation
• Special Tests:
  • Phalen’s, Tinel’s Sign – Carpal tunnel syndrome
  • Finkelstein’s Test – De Quervain’s tenosynovitis

Hip

• ROM: Flexion, extension, abduction, adduction, internal/external rotation
• Special Tests:
  • FABER Test – SI joint dysfunction
  • FADIR Test – Hip impingement

Knee

• ROM: Flexion, extension
• Special Tests:
  • Lachman’s, Anterior Drawer Test – ACL tear
  • McMurray’s, Apley’s Test – Meniscal tear

Ankle & Foot

• ROM: Dorsiflexion, plantarflexion, inversion, eversion
• Special Tests:
  • Anterior Drawer Test – Ankle instability
  • Thompson’s Test – Achilles tendon rupture
  • Windlass Test – Plantar fasciitis