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Haem Exam
 
 
 
 
Haem Exam
When examining a patient's haematologic system, remember the three key cell lines and the major manifestations that can result from their derangement: anaemia, infection and bleeding / bruising. The haematology exam is also used to identify signs of malignancy, such as lymphadenopathy and splenomegaly.
 

Joints of the Upper Limb

 
 

Joint Swelling

    • Look For

    • Generalised swelling over one or both upper limbs. May be associated with redness, tenderness or warmth.
    • Significance

    • May be a sign of an intra-articular bleed.
    • Causes of Joint Swelling

    • Intra-articular haemorrhage
    • Arthritis - osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, reactive arthritis, psoriatic arthritis
    • Trauma - fracture, dislocation, muscle sprain or rupture, compartment syndrome
    • Skin / soft tissue infection - cellulitis, abscess
    • Vascular - acute ischaemia, DVT, superficial thrombophlebitis, venous insufficiency, lymphoedema
    • Systemic - heart failure, cirrhosis, nephrotic syndrome, malnutrition
    • Tendinitis / bursitis

Reduced Joint Range of Motion

    • How to Perform

    • Ask the patient to move the joint themselves, and then passively move it for them. Note the range of motion and whether it is limited by pain, swelling or stiffness
    • Significance

    • May be a sign of an intra-articular bleed.
    • Causes of Limited Range of Motion

    • Intra-articular haemorrhage
    • Arthritis - osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, reactive arthritis, psoriatic arthritis, Reiter’s syndrome
    • Trauma - dislocation, fracture, ligamentous / menisceal tear
    • Loose intra-articular body
    • Fibrous adhesions
    • Muscle tightness
    • Prolonged joint immobilisation
    • Compartment syndrome
    • Tendinitis / bursitis
Last updated on January 1st, 2017
 
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