General practitioners (GPs) are frequently consulted by patients with complaints involving the musculoskeletal system. Some 15% of all diagnoses established by the GP can be traced back to problems involving the musculoskeletal system. The most frequently-occurring complaints are lower back pain, and knee and shoulder complaints. However, professional practitioners frequently encounter difficulties in performing a satisfactory examination, interpreting the findings from this examination and then treating the complaints concerned. There is, therefore, a high demand for training and professional development in this area.

The existing discrepancy between the aforementioned professional need on the one hand and the training currently provided on the other elicits several questions. Is structured and sufficient attention given to musculoskeletal examinations during the undergraduate medical degree? Is there sufficient knowledge of the functional anatomy, kinesiology and pathology in this area? To what extent does the complexity of the examination discourage students? Is the lack of consensus between various schools of thought confusing?

It is not the authors’ intention to provide a carefully-considered answer to these questions. Rather, our aim is to furnish the readers with the opportunity to improve and perfect their knowledge and skills in this area. Although the information provided relates to general practice, we certainly do not wish to limit ourselves to this professional group. We are of the opinion that medical students in particular, but also resident physicians, physiotherapists (in training) and posture and movement therapists can benefit from the material in this program.

The authors were confronted with several elementary obstacles when compiling this program. The first question was which method, movement or ‘school’ should be adopted as the basis for this program. For a number of reasons that will be stated later, the traditional orthopaedic approach was chosen. We believe that this method most closely relates to the frame of reference of our target groups. Additionally, the traditional orthopaedic method forms the basis for insights and methods developed more recently. Consequently, anyone who is (or aiming to be) thoroughly familiar with the principles of classical orthopaedics will have sufficient basic kmowledge to extend their knowledge and skills by looking into other schools of thought (e.g. manual therapy, orthopaedic medicine).

A second dilemma that the authors encountered was created by the wish to offer a didactically responsible method on the one hand (requiring a rigid systematic approach) and, on the other hand, to compile a program that is easy to read and attractively presented. We believe we have found a reasonable compromise through our extensive use of photos and illustrations. Yet the following needs to be mentioned beforehand: for some (selective) muscle tests, where necessitated by the complexity of the procedure, the photo illustrating how to hold the body part involved will be accompanied by a detailed description. However when performing these muscle tests, readers should realise that the approach illustrated is not necessarily the only correct one. Additionally, the description of the various structures in the text is often followed by an associated common condition.

The program has the following structure: the principles of the examination are discussed in section 2. The sections 3, 4 and 5 cover the examination of the hip, knee and foot/ankle respectively. Each of these sections starts with a part about the theoretical background (anatomy and kinesiology, terminology). Section 6 describes the various examinations for children, as many orthopaedic problems in children require a different approach than that in adults. Section 7 provides a number of case studies so that the competencies can be placed within the diagnostic framework. These case studies are a selection of the most frequently-occurring pathologies of the musculoskeletal system of the lower extremities. The aim is not to provide a complete picture but rather to aid a thorough and useful examination, even though the necessary schematisation inevitably leads to simplification. However, it should not be forgotten that the clinical picture is more complex and less clear cut than that in the cases described. In principle only the positive examination results are reported. The proposed therapies are more or less randomly ordered and are not scientifically supported due to a lack of scientific research. Furthermore, besides personal preference and the experience of the medical professional, the choice of therapy depends to a large extent on the patient’s wishes and abilities.