History
- • Pain — site, radiation, character, aggravating, morning stiffness
- • Swelling, deformity, instability, locking
- • Functional impact, occupation, prior injury
Examination sequence
- • WIPE — expose joint above + below, compare sides
- • Look: skin changes, swelling, deformity, scars, wasting
- • Feel: temperature, tenderness, effusion (patellar tap, bulge), neurovascular distal
- • Move: active then passive ROM; document degrees
- • Special tests: joint-specific (e.g. Lachman, McMurray for knee; Hawkins for shoulder)
- • Function: gait, grip, fine motor
Positive findings
- • Antalgic gait — pain in stance phase
- • Trendelenburg — gluteus medius weakness
- • Heberden/Bouchard nodes — OA
Differentials
- • Mono-arthritis: septic, crystal, trauma, haemarthrosis
- • Symmetrical polyarthritis: RA, psoriatic, viral
Viva questions
Q. Investigations for hot swollen joint?
A. Joint aspiration urgently (Gram, crystals, culture), bloods (FBC, CRP, urate), blood cultures, X-ray.
Q. Differential for back pain with red flags?
A. Cauda equina, malignancy, infection, fracture, AAA.
Common mistakes
- • Not exposing joint above and below
- • Failing to compare sides
- • Missing neurovascular check
