General Practitioners are often visited by patients who have complaints relating to the musculoskeletal system. The most common complaints are: lower back pain, knee, and shoulder complaints (Lamberts, In het huis van de huisarts [Inside the GP’s Practice]) Regarding lower back pain (including lower back pain with radiation), the annual incidence rate in a GP practice is 36-38 per 1000 patients. The incidence of lower back pain with radiation and ischialgia is 6 per 1000 patients per annum. At a prevalence of 44 per 1000 patients, each week a GP with a practice of 2350 registered patients will consult with 1 to 2 patients with lower back pain.
Levels of physical-diagnostic examination, interpretation of the investigative findings and treatment of the symptoms often appear to be inadequate. The need for training and professional development in this area is considerable. The current discrepancy between care supply and demand raises a number of questions. This leads to questioning if sufficient structural and adequate attention is being given to locomotor examination during the medical education of trainee general physicians. Do GPs have sufficient knowledge of the (functional) anatomy, kinesiology and pathology in this area? To what extent does the complexity of the physical-diagnostic examination discourage people? Or are they discouraged by the lack of consensus within and between different schools?’

It is not the intention of the authors to provide a detailed answer to all those questions; in the first place it is our intention to allow the readers to increase and complete their knowledge and skills in this topic. Thanks to the implementation of the Framework 1994 physician training, it is clear where the focus lies within the physical-diagnostic examination of the musculoskeletal system.

As in previously published Skills in Medicine series issues regarding the musculoskeletal system, we opted for the classical orthopaedic approach as the basis for this program. Firstly, we feel that this method aligns best with the reference framework of our target groups. Secondly, the classical orthopaedic method forms the basis for subsequently developed insights and methods. One who is very familiar with, or learns, the principles of the classical orthopaedic examination will have sufficient basic knowledge to become involved with subsequent techniques (e.g. manual therapy, Cyriax).
In the text, next to most of the anatomical structures a common associated disorder is mentioned.

The structure of this program is as follows:
- Anatomy and kinesiology of the spinal column and general terminology
- Principles, technique and systematics of the physical-diagnostic examination
- Specific additional examination techniques
- Shape and posture abnormalities of the spinal column

Although the primary target audience is medical students, we certainly do not want to limit ourselves to this group. In our opinion, GP's (in training), as well as house officers/registrars, physiotherapists (in training) and other musculoskeletal therapists may extend their knowledge and insight by using this educational tool.