The goniometer MUST be placed on the skin for ALL extremity ranges of motion.

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Measuring range of motion with a goniometer hinges on aligning the device's axis with the joint's center of rotation and lining up its arms with the two limb segments. Skin contact is common because it helps you palpate the exact landmarks and keep the goniometer stable, but it isn’t an absolute requirement for every situation. The important factor is accurate alignment to the joint, not the fact that the instrument must touch the skin.

There are times you’ll measure with skin contact, and times you’ll work around clothing, dressings, or a splint. If you can still identify the underlying landmarks or use a stable reference surface under the skin or splint, you can position the goniometer correctly and obtain a valid measurement. The key principle is accurate axis placement and stability, not that the device must always sit directly on bare skin.