Rheumatological Examination Spine AND Lower Limbs

The answer first

Rheumatological examination of the spine and lower limbs is the short case where the pattern IS the diagnosis. Your job is threefold: name the pattern of joint or spinal involvement, split inflammatory from mechanical and degenerative disease, and catch the extra-articular clue that flags a systemic cause — then order only the tests that change management. A complete musculoskeletal anatomy underpins every manoeuvre, and a fifty-year review reaffirms that this anatomy remains the enduring backbone of rheumatological practice.^[1]

The FRACP candidate must defend three positions without hedging. The spine is examined for inspection, movement, special tests, and neurological sequelae. Each lower-limb joint runs a fixed sequence. And the whole examination folds in a general and neurological screen, because the disease is often systemic and the consequences are often neurological.^[1]

References5ShowHide

1. [1]Kalish RA, Wohlgethan JR, Liu N, Nemegyei JA, et al. Promoting the utilization of rheumatologic musculoskeletal anatomy: a 50-year travel log Clin Rheumatol, 2026.PMID 42334785
2. [2]Perrot S, Laroche F, Poncet C, Marie P, et al. Are joint and soft tissue injections painful? Results of a national French cross-sectional study of procedural pain in rheumatological practice BMC Musculoskelet Disord, 2010.PMID 20100351
3. [3]Venyte R, Schuster-Amft C, Behrendt F, Nyfeler N, et al. [Long-standing myalgia and hypouricemia in a young woman : Case report and review of the literature] Z Rheumatol, 2025.PMID 40810925
4. [4]Sukharomana M, Charuvanij S Implementation and assessment of a structured curriculum for a 4-week pediatric rheumatology rotation for pediatric residents BMC Med Educ, 2024.PMID 38263148
5. [5]Yamamuro K, Ide K, Arai Y, Muraoka H, et al. Association Between Participant Satisfaction and Self-Reported Clinical Practice Behaviors in a Nationwide Guideline Education Program Neuropsychopharmacol Rep, 2026.PMID 42448624