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Prinzipien der Mehr-Stufen-Diagnostik: Ein Instrumentarium zur Diagnose von Muskel-Skelett-Erkrankungen

Aim: Musculoskeletal disorders represent the main cause of absenteeism. The aim of this study was to develop a multi-step inventory of examinations (MSD), which exactly describes musculoskeletal disorders. Method: The MSD consists of four levels each with three blocks: Block A: general examination, Block B: cervical spine, shoulder, elbow, hand, Block C: chest, thoracic spine, lumbar spine, pelvis, hip, knee, foot. The first level of examination has 29 tests and the second level 67 tests. Results: The MSD was found to be highly practicable in clinical use. It takes an additional 41/2 minutes to perform all 29 tests of level 1. This can be further reduced to 21/2 minutes by incorporating the orthopaedic tests in the general examination. A reflex hammer is the only tool needed for level 1. All tests in level 1 are highly sensitive, which makes them an ideal screening method. Results can be recorded on standardized forms by marking with a cross. Conclusions: The MSD is a simple and practical tool for investigating musculoskeletal disorders. It may improve the occupational medical management and availability of health data related to working conditions.