Physical examination: important observations
| • Skin: rash, vasculitic lesions, café au lait spots, haemangiomas, psoriasis, poorly healed scars |
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| • Nail and nail bed changes |
| • Joints (including back): normal position/posture (bizarre?), asymmetry, normal landmarks visible, ranges of movement active/ passive (any hypermobility? table 4), evidence of inflammation—warmth, redness, pain tenderness—swelling—effusion (type of fluid?), soft tissue, skin, bone, limb length discrepancy |
| • Muscle spasm (can be overcome by passive movement?) |
| • Muscle wasting/weakness/neurological deficit |
| • Discrepancies |