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• Musculoskeletal assessment


  Assessment of musculoskeletal function focusing on determining range of joint motion, muscle strength and tone, and joint and muscle condition
• Musculoskeletal assessment


  • Can be performed as a separate examination or integrated with other parts of the total physical examination
  • Nurses can assess the patient's movements while performing other nursing care measures such as bathing or positioning
• Key components of musculoskeletal assessment

  • General inspection
  • Palpation (joints, bones & muscles)
  • Muscle tone and strength
  • Range of motion
• General inspection


  1. Ensure that the areas to be examined are fully exposed and the patient is resting comfortably

  2. Observe from side when standing

  3. Observe gait

  4. Inspect joint for swellings

  5. Inspect for skin changes in color, scars, previous surgery, rashes

  6. Inspect adjacent structures like wasting of muscles above and below a joint

  7. Always compare to opposite side
• Inspection of the hand and wrist joints

  1. Inspect both hands and wrists as one

  2. Inspect the front, back and sides of all joints

  3. Compare sides
• Inspection of the spine

  1. Ask patient to undress while providing privacy

  2. Inspect from the front, sides and behind ideally with patient sitting and standing

  3. Pay special attention on pigmentations, abnormal hair growth or unusual skin creases, alignment of the neck and shoulder symmetry
• Lordosis


  Excessive inward curvature of the lumbar spine
• Kyphosis


  Thoracic spine curves giving a round shouldered or hunched appearance
• Scoliosis


  Thoracic and/or lumbar spine curve laterally forming a S or C shaped
• Inspection of the lower limbs

  Observe position of the joints, pelvic tilting
• Movements of the hip joint

  • Flexion
  • Extension
  • Abduction
  • Adduction
  • Internal and external rotation
• Inspection of the knees


  1. Inspect, comparing knees with patient supine

  2. Detect swellings by loss of medial and lateral dimples suggestive of an effusion
• Bow-legs (genu varum)


  Common condition where the knees angle outward
• Knock-knees (genu valgum)


  Common condition where the knees angle inward
• Swelling locations


  • Over the patella in prepatellar bursitis (housemaid's knee)
  • Over the tibial tubercle in infrapatellar or anserine bursitis
• Inspection of the ankle and foot

  1. Inspect foot and ankles ideally with patient standing and more carefully with the patient supine

  2. Look at the shoes for abnormal wear or stretching
• Movements of the ankle and foot

  • Ankle: Dorsiflexion, Plantar flexion, Inversion, Eversion
  • Toes: Extension, Flexion, Abduction and adduction