You will be asked to examine the spine. Spot the diagnosis and move into this song and dance.
- [STAND AND LOOK]
- [WALK AND FEEL]
- Look at gait - walking aids, clumsiness
- Walking without aids
- Screening of Tip toe and toes up if no need aids
- [SPECIAL TESTS]
- Ask patient to stand with back to wall - measure occiput to wall distance
- Most normal people occiput will touch the wall and OWD is 0.
- Abnormal is > 2cm
- Palpate the back spinous process
- Sit and check chest expansion >5cm
- Come to front, check for chest expansion with hands below nipple line and expand
- [LIE DOWN]
- FABER test for SIJ
- Examine Hip for a/w Hip OA
- Hip ROM - limited in all directions
- Would like to do a Thomas test but may be difficult in this patient due to his kyphosis
- Examine Achilles attachment - “no enthesopathy”
- Complete my exam by doing:
- Offer to do neuro exam
- Eyes - for uveitis
- Lungs for fibrosis
- Other joints for enthesopathy
- History for function
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