OBSERVATION & POSTURE ANALYSIS

Observation is the first step of your physical examination. During observation you are trying to see any structural abnormalities that you can link to your patient’s complaints.

Landmarks: Frontal Plane (Front)

  • Line from the tip of the nose to the manubrium of the sternum
  • Level of the shoulders
  • Angle of clavicles
  • Nipples (in male subjects)
  • Height of the iliac crest
  • Anterior Superior Iliac Spine (ASIS)
  • Spacing between trunk and arms
  • Arm length differences: Height of finger tips
  • Level of the tip of the patella
  • Rotation of the patella (outward or inward position)
  • Valgus or Varus positioning of the knees?
  • Level of medial malleoli

Landmarks: Sagittal Plane

  • Line of Appleton/Lateral plumb line: Line from the earlobe through the head of the humerus
  • Head Position: Anterior or Posterior
  • Shoulders: Pro- or retracted
  • Cervical lordotic posture
  • Thoracic kyphotic posture
  • Lumbar lordotic posture
  • Level between ASIS and Posterior Superior Iliac Spine (PSIS): Average 15°
  • Hyperextension of the knees?

 

Landmarks: Frontal Plane (Back)

  • Head: Rotating or leaning to one side?
  • Scoliosis?
  • Level of the acromia
  • Level of the scapular spine (mostly at the height of Th3)
  • Inferior angle of the scapula (mostly at height of Th8)
  • Distance of the margo medialis of the scapula from the spine
  • Gluteal fold
  • Valgus or Varus positioning of the knees?
  • Level of Malleoli: Number of toes next to the Achilles tendon to determine rotation

Not every abnormality is pathological, but can be a functional adaptation!

Study Reliability Sn Sp LR+ LR-
Magee et al. (2014) NA NA NA NA NA