1. Locomotor systems
Examination

2. Locomotor systems
Examination
General examination related to rheumatological
diseases :-
1- Hair :- Alopecia

4. 2-Face: - *Skin e.g. tightness.
*Eye e.g. redness, upper eye lids
(Heliotrope rash)
*Malar rash.
*Discoid rash.
*Mouth ulcers.
*Tongue dryness.
*Face wrinkles
*Nose e.g. peaked nose.

10. 3- Hands:-
*Gottron papules.
*Raynaud’s phenomena.
*Joints &muscles.
*Skin:- shiny & tight.
*Fingers:- ulcers, scars, gangrene,
sclerodactly.

15. 4- Neck:- lymphadenpathy.
5- Feet :- *Ulcers.
*Raynaud’s phenomena.
*Amputation.
*Skin tightness.
*gangrene
*Joints & muscles.

16. Rheumatoid hand examination
Inspection
Deformity, muscle wasting, swelling, redness.
Palpation
Temperature, tenderness, type of swelling.
Active movement
Done by the patient.
Passive movement
Try to increase the range of movement.
Restriction caused by pain or ankylosis.

19. Power
-5 movement of thumb:-
Adduction, abduction, flexion, extension, apposition .
-flexion at MCP joint by lumbricals.
-flexion at PIP joint by flexor digitorum superficialis.
-flexion at DIP joint by flexor digitorum profundus.
-adduction of fingers by palmer interossii.
-abduction of fingers by dorsal interossii .

20. Check forearms
For subcutaneous rheumatoid nodules.

22. Investigations
1- CBC.
2- ESR.
3- CRP.
4- Rheumatoid factor.
5- X- ray in chronic disease.
6- Arthrosonography.
7- Serological tests.
8- Arthrocentesis:- Joint aspiration.

23. 9- synovial fluid analysis:-
- Number of cells.
- Glucose level.
- Gram stain.
- AFB.
- Culture & sensitivity.

25. 10- Arthroescopy & synovial biopsy.
11- MRI of the joint. eg Sacroiliac joint.
12- Investigations related to underlying disease.

26. Thank you