geriatrics
Physical Examination of the Older Adult
Musculoskeletal System
Joints are examined for tenderness, swelling, subluxation, crepitus, warmth, redness, and other abnormalities. Active and passive range of joint motion should be determined. The presence of contractures should be noted. Variable resistance to passive manipulation of the extremities (gegenhalten) sometimes occurs with aging. Certain abnormalities, particularly those in the hands, may suggest a specific disorder: (bony overgrowths at the proximal interphalangeal joints): Osteoarthritis (OA) None Subluxation of the metacarpophalangeal joints with ulnar deviation of the fingers: Rheumatoid Arthritis (RA) None (hyperextension of the distal interphalangeal joint with flexion of the proximal interphalangeal joint): Rheumatoid Arthritis (RA) None These deformities may interfere with functioning or usual activities. 