is the next stage of the examination. With the patient disrobed, place the entire palm of each hand first on the superior portion of both hemithoraces and then, gently though firmly, move the hand inferiorly to just below the twelfth rib. Repeat the process moving laterally and subsequently anteriorly; search for rib deformities, nodules, and areas of tenderness. In the face of a history of chest discomfort, ask the patient to point to the area(s) of greatest discomfort. Palpate the area with increasing firmness in an attempt to elicit tenderness and to assess if this maneuver reproduces the patient's symptoms. Pay particular attention to the costochondral junctions in patients reporting anterior chest pain to evaluate the possibility of costochondritis.