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Orthopedic Evaluation

Understanding Your Body’s Mechanics

    Your musculoskeletal system — which is comprised of 206 bones connected by joints, muscles, ligaments, tendons, and nerves — protects your internal organs, supports your weight, and allows you to move. It’s a complex, interdependent system where even a minor disruption can result in discomfort and physical limitation.

    Your orthopedic surgeon is trained to diagnose and treat any injury, deformity, or disease that interrupts this system. General orthopedics covers all kinds of common and complex conditions like:

    • Back and neck pain
    • Sprains and strains
    • Fractures and dislocations
    • Cartilage and ligament tears
    • Bursitis and tendonitis
    • Arthritis
    • Osteoporosis
    • Congenital defects and abnormalities
    • Bone and soft tissue tumors

Questions Your Doctor May Ask You

    Ready to see an orthopedic specialist about joint replacement to relieve your pain? Before you go, consider how you’d answer certain questions he or she may ask. Your specialist should also ask questions about your medical and health history. Of course, you should be as thorough as possible when answering.

    • Where is your pain located? Does more than one joint hurt?
    • When did the pain first begin? What caused it (if known)?
    • Rank your pain on a scale of 1 to 5
    • Has the pain gotten worse recently? If so, is it more severe, does it occur more often, or both?
    • Does your pain get worse, or occur more often, when you do weight-bearing activities (Example: walking), at rest, or at night?
    • Are you taking any medication for the pain? (Make a list of both prescription and non-prescription medications.)
    • Are you taking any dietary supplements? (Make a list of vitamins or other “pills” for arthritis, such as chondroitin or glucosamine.)
    • How far can you walk without support? With support?
    • Can you climb stairs comfortably without help? Do you need to go very slowly and carefully?
    • How physically active are you?
    • What tests have previously been done to evaluate your joint pain?

Questions To Ask Your Doctor

    The questions below provide a way to discuss your joint pain with your doctor or specialist, and whether you’re a joint replacement candidate. Take them with you to your doctor, and be sure to ask any additional questions you may have to address your concerns:

    • Are there any pain relief options for me that could work as well as joint replacement?
    • If I have joint replacement, how much will it relieve my pain?
    • How is the procedure done?
    • What do you do to manage the pain after the surgery?
    • What are the risks or complications of joint replacement?
    • How long will I be in the hospital, and how soon after having the procedure can I get back to normal daily activities?
    • Is joint replacement covered by my insurance?
    • After the procedure, will I see you or my regular doctor for follow-up care?
    • If I decide to have joint replacement, which company’s product do you think will be best for me? Why?
    • If I have joint replacement, will you perform my surgery? How many of these procedures have you performed?
    • What kind of activities will I be able to participate in after joint replacement?

The Orthopedic Evaluation

    While every orthopedic evaluation is different, there are many commonly used tests that an orthopedic surgeon may consider in evaluating a patient’s condition.

    In general, the orthopedic evaluation usually consists of:

    • A thorough medical history
    • A physical examination
    • X-rays
    • Additional tests, as needed

    Your medical history is taken to assist the orthopedic surgeon in evaluating your overall health and the possible causes of your joint pain. In addition, it will help your orthopedic surgeon determine to what degree your joint pain is interfering with your ability to perform everyday activities.

    What the physician sees during the physical examination — which includes examination of standing posture, gait analysis (watching how you walk), sitting down, and lying down — helps to confirm (or to rule out) the possible diagnosis. The physical exam will also enable the orthopedic surgeon to evaluate other important aspects of your hips and knees, including:

    • Size and length
    • Strength
    • Range of motion
    • Swelling
    • Reflexes
    • Skin condition

    If you are experiencing pain in your hip joint, your back may be examined because hip pain may actually be the result of problems in the lower spine.

    After the physical examination, X-ray evaluation is usually the next step in making the diagnosis. The X-rays help show how much joint damage or deformity exists. An abnormal X-ray may reveal:

    • Narrowing of the joint space
    • Cysts in the bone
    • Spurs on the edge of the bone
    • Areas of bony thickening called sclerosis
    • Deformity or incorrect alignment

    Occasionally, additional tests may be needed to confirm the diagnosis. Laboratory testing of your blood, urine, or joint fluid can be helpful in identifying specific types of arthritis and in ruling out certain diseases. Specialized X-rays of the back can help confirm that hip pain isn’t being caused by a back problem. Magnetic Resonance Imaging (MRI) or a bone scan may be needed to determine the condition of the bone and soft tissues of the affected joint.

    In order to assist the orthopedic surgeon in making a diagnosis, it may be helpful to write down your answers to the following questions before the appointment:

    • Where and when do I have pain?
    • How long have I had this pain?
    • Do I have any redness or swelling around my joints?
    • What daily tasks are hard to do now?
    • Did I ever hurt the joint or overuse it?
    • Does anyone in my family have similar problems, such as spurs on the edge of the bone?

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