Enter
Greet the Examiner
Sanitize your hands
Introduce yourself to the examiner
Keep a Pillow
CHECK FOR ANY BOUTONIERRES, ZLINE, SWAN NECK DEFORMITIES, CHECK FOR ANY HEBERDEN OR BOUCHARDS NODULES, CHECK FOR RHEUMATOID NODULES, ALSO CHECK FOR GOTTRONS PAPULES, MUSCLE WASTING, RASH
LOOK AT THE JOINTS, SEE FOR ANY DEFORMITIES,
TOUCH IF THERE IS NO TENDERNESS, FEEL FOR THE JOINTS
SEE MCP/PIP JOINTS, CHECK FOR SKIN TIGHTENING, CHECK FOR DIGITAL ULCERS, CHECK FOR RAYNAUDS,
ASK THE PATIENT TO MAKE A FIST AND RELEASE.
ASK THE PATIENT TO MAKE A PRAYER SIGN AND REVERSE PRAYER SIGN
ASK PATIENT TO MAKE A O,
SEE THE NECK FOR SALT AND PEPPER RASH OF SCLERODERMA, SHAWL SIGN OF DERMATOMYOSITIS, ANY SCALES DUE TO PSORIASIS
ANY SKIN LESION IN BACK PALPATE THE SPINE FOR TENDERNESS
LOOK BEHIND THE EARS FOR PSORIATIC RASH AND GOUTY TOPHI
LOOK FOR PALLOR, ICTERUS, EPISCLERITIS, SCLERITIS, SCH AND YOU WILL NOT BE ABLE TO EVERT THE LOWER EYE
LID IN CASE OF SYSTEMIC SCLEROSIS
LOOK FOR ORAL ULCERS, CYANOSIS AND AS WELL
AS DIFFICULTY IN OPENING MOUTH IN CASE OF SCLERODERMA
LOOK FOR MALAR RASH
EDEMA, VASCULITIC RASH, PYODERMA
GANGRENOSUM, LIVEDO RETICULARIS, ANY SIGNS OF DVT, ULCERS AND VARICOSITIES.
SEE FOR ANY SURGICAL SCARS IN THE HANDS AND IF PERMITTED DO TINEL SIGN IF NOT DO NOT ATTEMPT IT.
ASK PATIENT TO FLEX AT ELBOW AND SEE EXTENSOR SURFACE OF THE HANDS TO LOOK FOR PSORIATIC RASH AND
RHEUMATOID NODULES AND GOUTY TOPHI.
LOOK AT PALS FOR ANY ATROPHY/MUSCLE WASTINGLOOK FOR PALMAR ERYTHEMA
CHECK FINGER GRIP
ASK THE PATIENT TO PICK UP ANY OBJECT LIKE A COIN OR PEN
CHECK THE PULSE
ORDER BLOOD PRESSURE
PALPATE FOR SPLEEN, LIVER AND KIDNEYS
CHEST: AUSCULTATE FOR LOUD P2 + ANY MURMUR AND BASAL CREPS AND APICAL CREPS TOO
ABDOMEN: AUSCULTATE FOR RENAL BRUIT IN CASE OF SCLERODERMA, RENAL CRISIS OR LUPUS NEPHRITIS
Concluding: Thank the patient, offering to help dress him up, wash hands and turn to the examiner.
