An Orthopedic inspection is performed by docteur Cardoso or Lapointe who will check the bones for alignment, deformities or shortening. This is followed by examination of the soft tissues for shape and contours making sure to make a bilateral comparison. He will look for any skin discolorations including cyanosis, pigmentations, etc. He will palpate the part complained of checking the bones, skin, temperature, and soft tissues for signs of spasm, atrophy or wasting any areas of local tenderness fasciculation’s or an abnormal tissue.
Range of motion both active and passive is initiated with pain responses noted as to degree and occurrence of pain or manifestations. Dr Cardoso or Dr Lapointe will look at the creptations during the active and passive motion. In cervicothoracic injuries, ROM for the cervicothoracic spine, shoulder, elbow, wrist and hand will be verified. In lumbosacral injuries, lumbosacral ROM as well as hip, knee, and ankle will be verified. He will note the degree of the patient pains upon motion as mild, slight, moderate, and severe and note the motion eliciting the pain.
Dr Cardoso or Dr Lapointe measure the strength and power of the muscles that are responsible for each movement of the joint. This is classified into”
0=No contraction (zero)
1=Flicker of contraction (trace)
2=Slight power sufficient to move the joint (poor)
3=Power sufficient to move the joint against gravity (fair)
4=Power to move the joint against gravity plus added resistance (good)