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Bone study
Last reviewed: 05.07.2025
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When examining the skeletal system (bones), first of all, attention is paid to the patient's complaints. Thus, sharp, suddenly appearing pains after an injury may indicate bone fractures; dull, gradually increasing pains in the bones are often associated with some inflammatory process; persistent, debilitating, often clearly localized pains occur with metastases to the bones of malignant tumors.
Inspection, palpation and percussion
During the examination, the presence of various deformations of the bones of the skull, spine, chest, pelvis, and limbs is determined. Thus, changes in the shape of the lower limbs in the form of X-shaped (genu valgum) or O-shaped (genu varum) legs can be noted. Shortening of one of the limbs can be detected with osteomyelitis. In this case, the examination is necessarily carried out with the patient in different positions, as well as during his movement.
In acromegaly, there is excessive enlargement of the fingers and toes, cheekbones, and lower jaw. In patients suffering from congenital heart defects, infective endocarditis, liver cirrhosis, and bronchiectasis, the terminal phalanges of the fingers thicken, causing the fingers to take on the characteristic shape of drumsticks. In patients with systemic scleroderma, changes of a different kind are observed, when, due to the destruction of the terminal phalanges, the fingers shorten and become pointed, sometimes taking on the shape of a short-sharpened pencil. Various changes can often be detected during examination of the bones of the chest and spine (for example, funnel chest, kyphosis, scoliosis, etc.).
Important diagnostic data concerning various changes in bone tissue can be obtained in a number of cases using palpation and percussion methods. Thus, palpation can more accurately detect thickening of individual bones (for example, "rachitic beads" of the ribs), determine the unevenness of their surface and pain upon palpation (with periostitis ), and detect pathological fractures. Pain when fingering flat and tubular bones (skull, sternum, ribs, spine, iliac bones, tibia, etc.) is observed with changes in bone tissue caused by certain blood diseases (anemia, leukemia, myeloma ) and metastases of malignant tumors to the bones.
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