Haem Exam


The Patient

The Hands

The Arms

The Face

The Neck

The Chest

The Abdomen

The Pelvis

The Back

The Legs

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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
    • Pathological 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