Journal article
Building Consensus on the Essential Elements of the Musculoskeletal Physical Examination during Rheumatology Telehealth Encounters
Arthritis care & research (2010), Vol.78(5), pp.683-687
05/2026
DOI: 10.1002/acr.25669
PMID: 41139807
Abstract
Objective
Patients and providers encounter challenges when conducting virtual musculoskeletal physical examinations (PEs) during rheumatology telehealth encounters. Guidance for a structured virtual PE could enhance the quality of clinical information gleaned and management decisions made during rheumatology telehealth visits. This study aims to build expert consensus and identify the most essential elements as the first step in defining the virtual rheumatology musculoskeletal PE.
Methods
A team with expertise in rheumatology telehealth, consisting of rheumatology attending physicians, educators, and a patient with rheumatic disease, conducted a modified Delphi to achieve consensus on the items determined to be most essential to the virtual rheumatology musculoskeletal PE. The modified Delphi consisted of two online surveys and a virtual meeting.
Results
The team identified seven items essential to the rheumatology musculoskeletal telehealth PE. These items describe elements in a focused joint exam as well as the assessment for level of activity of inflammatory arthritis. The modified Delphi method excluded maneuvers related to assessment of muscle strength and widespread pain syndromes, determining that these elements were better conducted in person.
Conclusion
A list of PE items most essential to rheumatology musculoskeletal telehealth encounters, supported by expert opinion and established evidence, marks the first step towards standardizing, evaluating, and teaching the virtual rheumatology PE. These items, alongside anticipated future revisions and improvements, promise to enhance the quality of telehealth care delivered to people with rheumatic diseases.
Details
- Title: Subtitle
- Building Consensus on the Essential Elements of the Musculoskeletal Physical Examination during Rheumatology Telehealth Encounters
- Creators
- Lisa Zickuhr - Washington University in St. Louis School of MedicineAlberto Sobrero - Massachusetts General HospitalDaniel Albert - Dartmouth CollegeAmanda S. Alexander - University of Alabama at BirminghamTami Bonnett-Admi - 3GEM Consulting Washington DCSarah Dill - Lakeview Rheumatology Yakima WASharon Dowell - NEA Baptist Memorial HospitalElizabeth D. Ferucci - Alaska Native Tribal Health ConsortiumConnie Herndon - American College of RheumatologyBharat Kumar - Iowa Carver College of Medicine Iowa City IADavid Leverenz - Duke UniversityJennifer Mandal - University of California, San FranciscoIrene J. Tan - Einstein Healthcare NetworkSwamy Venuturupalli - Cedars-Sinai Medical CenterTiffany Westrich-Robertson - AiArthritis, Inc St. Louis MOMarcy B. Bolster - Massachusetts General HospitalJason Kolfenbach - University of Colorado Anschutz Medical CampusAmerican College of Rheumatology Workforce Solutions Committee
- Resource Type
- Journal article
- Publication Details
- Arthritis care & research (2010), Vol.78(5), pp.683-687
- DOI
- 10.1002/acr.25669
- PMID
- 41139807
- NLM abbreviation
- Arthritis Care Res (Hoboken)
- ISSN
- 2151-464X
- eISSN
- 2151-4658
- Publisher
- WILEY
- Grant note
- Pfizer: 76770947 Rheumatology Research Foundation Clinician Scholar Educator Award
Supported by a Pfizer education grant (grant 76770947) and the Rheumatology Research Foundation Clinician Scholar Educator Award.
- Language
- English
- Electronic publication date
- 10/26/2025
- Date published
- 05/2026
- Academic Unit
- Immunology; Internal Medicine
- Record Identifier
- 9985019146002771
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