One important field of manual medicine is the special diagnosis and treatment of the extremities. Biomechanical and neurophysiologic knowledge allows identification and treatment of so-called kinetic chain syndromes. The manual diagnosis of the extremities follows clear criteria and enables the diagnosis of myofascial or joint dysfunction. The manual approach to the extremities has many parallels with spinal treatment, although in certain cases, it follows a distinct algorithm. This article addresses the manual diagnosis and treatment of the joints of the extremities. Three case reports demonstrate how symptoms and manual findings guide manipulative treatment and what impact this can have.