Diagnostics

A clinical examination for a sound diagnosis

What is causing your symptoms? A diagnosis that is as precise as possible provides the basis for choosing the right treatment. At OrthoCoast in Wolgast, we bring together your medical history, physical examination and any further findings. This helps us understand the cause of your symptoms and plan the next step with you.

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Understanding

Understanding symptoms and distinguishing their causes

Similar symptoms can have different causes. Pain around a joint, for example, may come from the joint itself, a tendon or a neighbouring structure. Sometimes there is more than one possible explanation. We call these alternatives differential diagnoses. Our aim is to identify the diagnosis that best explains your symptoms and the findings. We also look for observations that argue against an initial explanation. It is not always possible to identify a cause clearly at the first appointment; if so, we discuss what information is still missing and how to obtain it in a focused way.

We start with your medical history, also known as the anamnesis. This is followed by a focused physical examination. We then decide whether imaging or laboratory tests, for example, are needed. It is the combined assessment of this information that enables a sound diagnosis in orthopaedics and osteology, including questions about bone health.

How we test an initial explanation

The discussion gives us an initial idea of what might be causing your symptoms. During the physical examination, we check whether that explanation fits the findings. Which movement brings on your familiar pain? Is a joint stable? What are your strength and sensation like? Depending on the question, we also examine neighbouring areas of the body. A single test rarely determines the diagnosis on its own. What matters is whether your medical history, examination findings and existing results fit together. If they conflict, we consider other possible causes and assess whether further tests could help distinguish them.

Bone health and its links with other medical conditions

A clinical examination is also part of an assessment of bone health. Alongside previous fractures and falls, we ask about changes in height and assess spinal posture and mobility, muscle strength, walking and balance. Which aspects we examine more closely depends on your history and current symptoms. A single posture test can neither reliably diagnose nor rule out osteoporosis.

Bone health is also linked to other conditions and medicines. An assessment of bone health also considers possible causes related to internal medicine and coexisting conditions. The discussion, physical findings and, where needed, targeted laboratory tests help us assess these connections. A DXA bone density scan adds a different piece of information to this assessment: it measures bone mineral density. Which examinations are needed together and whether an additional opinion from another specialist would be helpful are decided individually.

Sources on clinical assessment and bone health investigations

Further information

Your feedback is part of the examination

Please tell us where and when a movement causes symptoms. You do not need to “put up with” a test or achieve the greatest possible range of movement. If something is very painful or you feel unsure, we adapt the examination. A test that shows no abnormality can also provide valuable information. Individual examination findings rarely prove a diagnosis on their own. Their significance comes from the overall pattern: what symptoms do you describe, what does movement show, are there neurological abnormalities, and which findings are already available? This is precisely why an in-person examination cannot be fully replaced by a questionnaire, an image or a video clip.

What to expect and next steps

From discussion to physical examination

We first discuss when your symptoms began, how they have developed and how they affect you. We ask about injuries, previous conditions and treatments, your medicines and the demands of everyday life. Your observations help us put the symptoms into context and consider possible causes. The physical examination is then guided by that question. For example, we look at posture, walking, joint alignment or swelling. We assess movement, examine the affected area by touch and use appropriate functional tests. If symptoms radiate or nerve involvement is suspected, we may also check strength, reflexes and sensation. Not every patient needs every part of the examination.

What you can prepare

Please bring any existing medical letters, operation reports, scans or X-rays with their reports, and an up-to-date medication list. For a recent injury, it helps to know when and how it happened. If your symptoms have been present for longer, you can note which activities you can manage, for how long, and what makes things better or worse. Comfortable clothing makes examination easier. Depending on the area, you may need to uncover the affected joint or your back. Your privacy matters; please tell us if you would like an explanation before part of the examination or would like someone to accompany you. Bring aids such as a brace, insole, walking stick or splint if they relate to the problem or your treatment so far.

Interpreting further findings and discussing the diagnosis

After discussing your symptoms and examining you, we assess whether the available information is sufficient for a diagnosis and further planning. If an important question remains unanswered, ultrasound, X-rays, MRI, CT, functional assessment, laboratory tests or an opinion from another specialist may be useful, depending on the suspected cause. The appropriate examination depends on which possible causes we need to distinguish. Any additional findings are then considered together with your medical history and examination findings. An abnormal image or a single laboratory value does not automatically explain symptoms. We discuss which diagnosis best fits the results, how certain that assessment is, and what treatment or further investigation follows from it. If your symptoms change or new findings become available, we review our assessment.

What matters for your decision

Doctors, appointments and possible costs

Your contacts for a clinical orthopaedic examination are Priv. Doz. Dr. med. habil. Richard Kasch, Dr. med. Christoph Jährling and Björn Weidemann. Dipl. med. Matthias Dallmann also carries out examinations as part of individually agreed cover arrangements. We arrange which doctor will see you according to your needs and the appointments available. To get started, use “Appointments & enquiries”. If you have German statutory health insurance, you do not need to sign a self-funding agreement for the consultation or services billed to your health insurer. If you would like an additional service that your insurer does not cover, you will receive a cost estimate beforehand. We discuss the scope of the service and the expected costs with you. We only provide this self-funded service once you have signed to confirm in writing that you wish to have the treatment and agree to pay for it. Without this prior agreement, you will not incur any charges with us for an additional self-funded service.

Our doctors in this specialty

Priv. Doz. Dr. med. habil.Richard Kasch

Specialist in orthopaedics and trauma surgery

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Dr. med.Christoph Jährling

Specialist in orthopaedics and trauma surgery

DVO-certified osteologist

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Björn Weidemann

Specialist in orthopaedics and trauma surgery

DVO-certified osteologist

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These doctors consider your symptoms, mobility and everyday life together. Your observations help us discuss the next steps with you.

Frequently asked questions

Does a clinical examination hurt?

Some movements or tests may bring on familiar symptoms because that is the very pattern being examined. Please tell us immediately. The examination is adapted to what you can manage.

Will I need to undress for the examination?

We often need to be able to see and move the affected area. We explain what is necessary. Comfortable clothing is helpful, and your privacy is respected.

Does the examination replace an MRI scan?

No — and an MRI scan does not replace a clinical examination either. They answer different questions. Whether imaging is needed depends on your individual circumstances.

Can treatment start at the first appointment?

This depends on the findings, the preparation required and the practical arrangements. We discuss whether starting treatment straight away is appropriate and possible or whether another appointment is needed. Particularly if you have a long journey, we try to coordinate examinations and treatment sensibly and avoid additional trips where possible.

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A clinical examination for a sound diagnosis

Understanding