Netter's Orthopaedic Clinical Examination

Wrist and Hand

Clinical Summary and Recommendations Patient History Complaints Overall subjective complaints do not appear useful in identifying carpal tunnel syndrome. Only reports of “dropping objects” and “shaking hand improves symptoms” statistically altered the probability of the diagnosis and then only minimally…

Elbow and Forearm

Clinical Summary and Recommendations Patient History Complaints Little is known about the utility of subjective complaints with elbow pain. Physical Examination Range-of-Motion Measurements Measuring elbow range of motion has consistently exhibited good to high reliability for assessing flexion, extension, supination,…

Shoulder

Clinical Summary and Recommendations Patient History Complaints Little is known about the utility of subjective complaints with shoulder pain. Although a report of trauma does not seem clinically useful, a history of popping, clicking, or catching may be minimally helpful…

Foot and Ankle

Clinical Summary and Recommendations Patient History Complaints No studies of acceptable quality have assessed either the reliability or diagnostic utility of items from the subjective history in patients with foot and ankle problems. Physical Examination Screening The Ottawa Ankle Rule…

Knee

Clinical Summary and Recommendations Patient History Complaints Little is known about the utility of subjective complaints with knee pain. The absence of “weight bearing during trauma” may help rule out a meniscal tear (likelihood ratio [LR] = .40). Symptoms in…

Hip and Pelvis

Clinical Summary and Recommendations Patient History Complaints Several complaints appear to be useful in identifying specific hip pathologic conditions. A subjective complaint of “clicking in the hip” is strongly associated with acetabular labral tears. Reports of “constant low back/buttock pain”…

Sacroiliac Region

Clinical Summary and Recommendations Patient History Questions The question “Is pain relieved by standing?” is the only question studied to demonstrate some diagnostic utility (+LR [likelihood ratio] of 3.5) for sacroiliac joint pain. Pain Location Recent evidence suggests that patients…

Thoracolumbar Spine

Clinical Summary and Recommendations Patient History Complaints A few subjective complaints appear to be useful in identifying specific spinal pathologic conditions. A report of “no pain when seated” is the answer to the single question with the best diagnostic utility…

Cervical Spine

Clinical Summary and Recommendations Patient History Complaints The utility of the patient history has been studied only in the context of identifying cervical radiculopathy. Subjective reports of symptoms were generally not helpful, with diagnoses including complaints of “weakness,” “numbness,” “tingling,”…

Temporomandibular Joint

Clinical Summary and Recommendations Patient History Questions Screening instruments have been shown to be very good at identifying temporomandibular disorder (TMD) pain (+LR [likelihood ratio] of 33). A subject complaint of “periodic restriction” (the inability to open the mouth as…