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During my third year of Internal Medicine Residency, I encountered a patient with severe, long-standing psoriatic arthritis. After examining him (as best I could) and recording all his deformities (having only a vague idea of how to effectively describe them), I presented him to my attending. After patiently listening to me stumble through my findings, he asked "Geordie, was there any synovitis, any joint swelling?" I was dumbfounded. I had no idea. My Rheumatology fellowship followed shortly thereafter and for the first time I received excellent, systematic instruction in musculoskeletal physical examination techniques that I would build on for the rest of my life.

If you are reading this, you have a book in front of you. As such, it runs the risk of becoming "just another physical examination book." Physical examination techniques are not intellectual concepts but skills to be developed. As such, they require education of our eyes and hands, not just our brain. As with any activity involving our eyes and hands, increasing skill development only occurs with practice.

Systematic Musculoskeletal Examinations © is intended to bring a fresh approach to musculoskeletal examination instruction through the combined use of printed text (what you have before you), web-delivered self study programs (to parallel written material) with video instruction, graphics, animations and hotlinks to illustrative examples of key abnormalities plus additional web-delivered skill-building workshops (for supervised or independent hands-on practice).

My intention is that Systematic Musculoskeletal Examinations © meet three key requirements:

  1) To develop a set of user-friendly, efficient, practical, and reproducibly effective basic examinations which can be readily integrated into the time demands of a busy outpatient practice.
  2) To make effective use of on-demand, multimedia instruction to amplify and clarify static images on a printed page.
  3) To provide learners a useful frame work for further skill development in musculoskeletal examination techniques for the rest of their careers.

It is my hope that this curriculum brings satisfaction and joy to you personally and greatly benefits patients with musculoskeletal problems who present for your assessment and management.

Geordie Lawry
July 2011

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