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
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.
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.