Bone examination
Last reviewed: 23.04.2024
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When examining the bone system (bones), first of all pay attention to the patient's complaints. So, sharp, suddenly appeared pains after a trauma can testify about fractures of bones; dull, gradually increasing pain in the bones are often associated with some kind of inflammatory process; persistent, debilitating, often clearly localized pains occur with metastases in the bones of malignant tumors.
Examination, palpation and percussion
When examined, the presence of various deformities of the bones of the skull, spine, thorax, pelvis, limbs is determined . Thus, changes in the shape of the lower extremities in the form of X-shaped (genu valgum) or O-shaped (genu varum) legs may be noted. The shortening of one of the limbs can be detected with osteomyelitis. In this case, the examination is necessarily carried out at a different position of the patient, as well as during his movement.
When acromegaly is observed an excessive increase in the fingers and toes, zygomatic bones, lower jaw. In patients suffering from congenital heart defects, infective endocarditis, liver cirrhosis, bronchiectatic disease, the terminal phalanges of the fingers are thickened, resulting in the fingers taking the characteristic shape of the drumsticks. In patients with systemic scleroderma, changes of a different kind are noted, when, as a result of the destruction of the terminal phalanges, the fingers of the hands are shortened and sharpened, sometimes acquiring the shape of a shortened pencil. Various changes can often be detected by examining the bones of the chest and spine (for example, funnel-shaped breasts, kyphosis, scoliosis, etc.).
Important diagnostic data on various changes in bone tissue can be obtained in a number of cases using the methods of palpation and percussion. Thus, when feeling, it is possible to more accurately identify the thickening of individual bones (for example, "rachitic rosary" of the ribs), determine the unevenness of their surface and tenderness in palpation (with periostitis ), and detect pathological fractures. Soreness in the process of pinching the fingers on the flat and tubular bones (skull, sternum, ribs, spine, iliac bone, tibia, etc.) is observed with changes in bone tissue caused by certain blood diseases (anemia, leukemia, myeloma ) and metastases in the bones of malignant tumors.
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