● During inspection, look for symmetry of involvement. Is the change in joints symmetric on both sides of the body, or is the change only in one or two joints? 

Note any deformities or malalignment of bones or joints.

● Use inspection and palpation to assess the surrounding tissues, noting skin changes, subcutaneous nodules, and muscle atrophy. Note any crepitus, an audible or palpable crunching during movement of tendons or ligaments over bone or areas of cartilage loss. This may occur in joints without pain but is more significant when associated with symptoms or signs.

● Test range of motion and maneuvers (described for each joint) to demonstrate limitations in range of motion or joint instability from excess mobility of joint ligaments, called ligamentous laxity.

● Finally, test muscle strength to aid in the assessment of joint function.

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