Review of Specific Symptoms

The most common symptoms of musculoskeletal disease are as follows:

Weakness Deformity

Limitation of motion

Stiffness

Joint clicking

The location, character, and onset of each of these symptoms must be ascertained. It is important for the interviewer to determine the time course of any of these symptoms.

Extension

Flexion

Flexion

Lateral flexion

Lateral flexion

Figure 20-20 Range of motion at the cervical spine. A, Flexion and extension. B, Rotation. C, Lateral flexion.

Pain

Pain can result from disorders of the bone, muscle, or joint. Ask the following questions: ''When did you first become aware of the pain?''

''Where do you feel the pain? Point to the most painful spot with one finger.'' ''Did the pain occur suddenly?'' ''Does the pain occur daily?''

''During which part of the 24-hour day is your pain worse: morning? afternoon? evening?'' Did a recent illness precede the pain?'' ''What makes the pain worse?'' ''What do you do to relieve the pain?''

Spinous process

Vertebral body

Figure 20-21 Anatomy of the lumbar spine.

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