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; history, observation, examination mnemonic for assessment of musculoskeletal symptoms (Table 1)
Table 1: The history, observation, examination (HOE) model for assessment of patients with musculoskeletal symptoms
HistoryBiographical information
General medical history (such as duration of symptoms/disease, medications, disease activity markers)
Presenting symptoms - pain maps, patient-completed baseline health outcome measures)
ObservationNon-weight-bearingMusculoskeletal system/disease state:
  • Limb alignment

  • Joint/soft-tissue swelling

  • Dermal signs

Presenting complaint:
  • Dimensions and numbers of visible lesions

  • Record of tender/swollen joints

Footwear assessment
  • Suitability

  • Wear patterns

  • Distortion of uppers

Weight-bearingLimb alignment
  • Joint/limb segment alignment

  • Foot posture at relaxed calcaneal stance

Comparison with non-weight-bearing observations
Observation of gait
ExaminationProvocation of symptoms/pain
  • Palpation

  • Active motion

  • Passive motion

Systematic palpation and movement of structures, from proximal to distal
  • Bony structures

  • Joints

  • Soft tissues

  • Radiograph

  • Magnetic resonance imaging

  • HRUS

HRUS, high-resolution ultrasound.


n an angled instrument with the broad dimension of its blade perpendicular to the axis of the shank of the shaft.