Loss of muscle bulk may be due to local or systemic disease, generalised wasting can be observed in the hands, by examining the interossei over the dorsum, particularly between the thumb and index finger. Limb wasting can be measured at fixed points along it (page 349), comparing measurements on the two sides of the body. Be sure to use the same markers on each side, and record the distance and the circumference in the patient’s notes.
Measurement of the length of the whole or part of each limb establishes real or apparent shortening (page 144). The various segments are measured not only in developmental assessment, but also to demonstrate shortening due to congenital abnormalities or injuries.
Note the range of active and passive movement of a joint being examined.