Jones AC, Doherty M.
Medicine North America, 1995;18:991-998

A rapid rheumatology screen is used to identify locomotor problems. Skin changes, deformity, distress, joint or other swellings, muscle wasting and gait abnormalities should be looked for. When determining the patient's locomotor problems the following questions should be asked:

• Is there any pain or stiffness in the muscles, joints or back?
  
• Can washing and dressing be done without difficulty?
  
• Is walking up and down stairs painful or difficult?
  

When examining the joints the following may provide help in arriving at a diagnosis:

• Supraspinati tenderness is evidence of fibromyalgia, cervical spine or rotator cuff disease
  
• For crepitus glenohumeral rotation tests are necessary
  
• Vertebral stiffness may indicate lumbar spondylosis or ankylosing spondylitis
  
• Painful neck flexion may be a sign of cervical spondylosis or shoulder or rotator cuff lesions.
  

To test glenohumeral, acromioclavicular, sternoclavicalar and humero-ulnar joint function place the patient's hand behind the head and the elbow should be back. To test proximal and distal radio-ulnar joints flex the elbows at 90º and rotate the hands. Having the patient make a fist shows swelling of metocarpophalangeal joints.When the patient is lying on the examination table, a hand on the flexed knee and hip tests for crepitus, restricted movement and back pain. Flexed hips should be rotated to check for signs of hip disease.

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