Palpation


Procedure


  • The patient sits on a chair, with both lower arms placed on a table or examination table.
  • Position yourself opposite the patient.
  • Preferably, palpate using the fingertips.
  • Ask the patient to indicate precisely where and when it is painful.
  • In the case of abnormal findings, compare left and right.
  • Note:
    • Any swelling and its characteristics.
    • The muscle tone (fingers transverse to the direction of the muscle fibres).
    • Abnormal mobility.
    • Abnormal structures.
    • Discontinuity.

The following bones and joints are accessible for palpation:

  • Medial and lateral supracondylar ridges (fracture).
  • Medial epicondyle (golfer’s elbow) [Figure 94].

Figure 94


  • Ulnar nerve groove (dislocation of the ulnar nerve).
  • Lateral epicondyle (tennis elbow) [Figure 95].

Figure 95


  • Olecranon (fracture).
  • Humeroradial joint (dislocation) and radial head (dislocation).
  • Humeroulnar joint (rheumatoid arthritis) [Figure 96].

Figure 96


  • Posterior border of the ulna (fracture).

The following soft tissues are accessible for palpation:

  • Skin.
  • Muscles.
  • The other soft tissues are:
    • Subcutaneous olecranon bursa (bursitis).
    • Joint capsule (capsulitis, arthritis) – palpate this at the level of the humeroradial joint and the humeroulnar joint.
    • Ulnar nerve (dislocation, neuritis).

 

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