The stem will be very vague “examine UL and LL”
- “I will first examine the UL - can you please remove your shirt?”
- Remove shirt - look at scars in axilla, elbow, forearm
- shortened forearm
- bilateral radial head subluxations that appear to be cubitus varus
- Limited in pronation/ supination
- Examine the lump as an approach to lump
- Check NV quickly - comment no involvement of NV (MUR nerves, radial pulse)
- “I will now proceed to examine LL”
- Comment on alignment (valgus/ Varus)
- Gait - short limb gait?
- Multiple scars - could be from excision/ hemiepiphysiodesis/ osteotomies
- Multiple lumps
- Lie patient down
- Evaluate and measure Limb length; galeazzi to determine which bone is short
- Check distal NV - foot drop and pulses
- Complete my exam by:
- Take a history from patient - AD, recent enlargement/ pain to suggest concerns for malignant change, FUNCTION (How is it affecting you? What sport you cannot do but want to do?
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