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Haem Exam

 
 
 
The Patient
The Hands
The Arms
The Face
The Neck
The Chest
The Abdomen
The Pelvis
The Back
The Legs
 
 

The Back

 
 

Bony Tenderness

    • How to Elicit
    • Gently press over each spinous process, asking the patient if this elicits pain.
    • Significance
    • May be an indicator of malignancy.
    • Causes of Bony Tenderness
    • Traumatic fracture
    • Pathologic fracture - osteoporosis, osteomalacia, osteogenesis imperfecta, Paget’s disease of bone
    • Osteolytic lesions - multiple myeloma, bony metastasis, fibrous dysplasia, bone cyst
    • Osteosarcoma
    • Infection - osteomyelitis,  septic arthritis
 
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