Palpation

With the patient standing and then perhaps later, lying supine, palpate the back for the:

• skin temperature
• deformity of the spine - steps or a steady contour ?
• vertebral tenderness - localised or general ?
• paraspinal spasm and muscle tenderness
• sacro-iliac tenderness in sacroileitis

Elsewhere:

• feel for peripheral pulses
• palpate groin and abdomen for abscesses
• if diagnosis is still uncertain, carry out full thoracic, abdominal, rectal and vaginal examination