History and clinical examination in rheumatology--key to diagnosis and prognosis]

History and clinical examination are key to diagnosis and prognosis in rheumatology. In the area of soft tissue rheumatism, there is no other diagnostic possibility which could replace clinical examination. Clinical examination also plays a very important role in the diagnosis of the other rheumatic disorders. With a competent clinical examination one can often eliminate the need for additional costly and/or time consuming investigations. In addition, diagnosing by purely careful and competent clinical examination is a highly gratifying activity for the medical doctor. The competent examiner should also be able to derive prognostic conclusions directly from the clinical examination. This is especially important for the more frequent disorders such as soft tissue rheumatism or back problems, where diagnostic imaging is only helpful if interpreted in the context of the pertinent clinical question.