Orthopedic history taking Taiz University , faculty of medicine and health sciences by Dr : Ruba Alathwri .

1. 1st seminar done by:-
Ruba Alathwari
orthopaedic

2. Orthopedic surgeons:-
deal with deformity, diseases of bone
and joints, and injuries to the
musculoskeletal system.

3. Generally Dx depend on:-
1-Hx taking.
2-Physical examination.
3-Investigation

4. 1-personal Hx
2-chief complain(symptoms)
3-present Hx
4-past Hx
5-family Hx
6-social Hx
History taking of orthopedic pt :-

5. *The most common complaints in orthopaedic:
1- pain
2- swelling
3- stiffness
4- deformity
5- weakness
6- instability
7- change in sensibility
8- loss of function
*Personal history: N A S O M R A
Name-Age-Sex-Occupation-Marital state-
Residence-Address and date of Admission.
*Present history: analysis for chief complaint.

6. 1- Pain:- analysis by SOCRATES
- the most common symptom.
- ask pt to point to where it hurts.
-- pain in or near the skin is localized ,but in deep
structure is more diffuse as hip disease manifest
with pain in the knee.
-- autonomic pain affect the autonomic nerves is
more vague associate with vasomotor and tropic
changes.
- Pain is sharp, sudden onset, exaggerated
by movement, relived by rest and
immobilization, usually not referred.

7. 2-stiffness:-
- May be : generalized as in rheumatoid arthritis
or ankylosing spondylitis or localized to a
particular joint.
- Limited movement should never be assumed
until verified by examination.
-Ask when it occur:- early morning stiffness of
many joint is rheumatoid arthritis, transient
stiffness 1 or 2 joint after period of inactivity is
osteoarthritis.
- locking:- sudden inability to complete a certain
movement suggest mechanical block.

8. 3- swelling:-
- May be in soft tissue, joint, or the bone.
- If appear rapidly following injury is hematoma
or haemarthrosis.
-- If appear slowly is tissue inflammation or joint
effusion.
- If it is painful , may due inflammation.

9. 4- deformity:-
-- Some is variation of normal as: wide
hips.
-- Some disappear spontaneously with
growth as: flat feet.
- Some is progressive if appear on only
one side of body.

10. 5-weakness:-
- If affecting single of muscles suggest
neurologic disorder.
- Prolong joint dysfunction will lead to weakness.
6-instability:-
- Due to ligamentious deficiency, recurrent subluxation.
7-change in sensiblity:-
Tingling or numbness interference with nerve
function may due to pressure from neighboring
structure as in prolapse intervertebral disc.
8- loss of function.

11. *Past Hx:-
ASK about previous
accident,illness,operation and drug therapy.
*Family Hx:-
ASK about MSS in pt’s family help in Dx and
counseling.
*Social Hx:-
ASK about detail of work, smoking…
*Systemic review.