LE Flashcards
You have a female patient come into your office that you notice is slightly knocked-kneed she complains of deep knee pain especially when climbing stairs. What aspect of her anatomy is most likely contributing to her pain? What is her diagnosis?
Wide hips increase Q angle of the knee contributing to her genu Valgum. This is most likely patello- femoral syndrome.
Your patient is having leg pain with exercise that hurts even worse with stretching. You notice on physical exam that the anterior tibialis is hard and tender. What’s your major concern? Can this be treated with OMT?
This is likely anterior compartment syndrome that may require fasciotomy.
Yes, to a point. ICE and myofacsial release to increase lymphatics, but if pressure remains high this can lead to muscle necrosis within 4-8 hrs.
Explain a positive Obers test
This is a test for a tight iliotibial band. Simply raise the leg with hip flexion then release the knee while holding the leg and if the knee does not move down toward the opposite leg, but remains in the air this is a positive test.
What’s is the cause of a trendelenburg gait?
The trendelenburg screens for hip weakness in the abductors (gluteus medius). A positive test indicates weakness of the muscle on the supported side (weighted side) this weakness prevents the support of the contralateral leg causing the patient to fall toward the opposite leg.
Whats the hip drop test?
Patient stands then slightly flexes the knee (i.e. Left) allowing for ipsilateral sidebending, there should be concomitant lumbosacral spinal sidebending on the right side.
If there is straitening of the normal C-curve induced by sidebending this is indicates dysfunction of the lumbar region.
What can cause a snapping hip?
IT band most commonly snaps over greater trochanter when walking or rotating hip (ass: bursitis). The hip may hurt to lay on at night.
Iliopsoas tendon slideds over pectineal eminence of the pelvis. Usually felt in the groin while getting out of a chair during hip extension.
Intra-acticular tears of the labrum (disabling) may reach for support.
What should you think of with pain in the lateral hip?
Jones counterstrain points
and Iliolumbar ligament sclerotomal pain “dull and achy”
Piriformis syndrome (sciatica) usually presents how?
buttock pain that radiates down the leg to the knee especially during a strait leg or dorsiflexion test.
What are the primary functions of the piriformis during hip extension and flexion?
Extension-external rotation
Flexion -abduction
What motion will accompany IROT, and EROT of the knee?
IROT-Posterolateral glide
EROT-Anteromedial glide
Think of squishing a bug, where is your heel moving during rotation?
What is lachmans test used for, and how do you do it?
More specific test for the ACL, check for tear. Flex the leg 30 degrees then pull up on the tibia while holding the femur down.
What’s Apley’s compression and distraction test used for and how do you do it?
Look for ligament damage at the knee. Flex leg press down while rotating, or lift leg at the foot and rotate.
What’s the bounce home test for?
Test meniscus and patella. Just flex the leg then drop it.
Your patient is an avid cyclist with lateral knee pain. You notice she also has some genu varum. Obers test is positive, what’s the most likely diagnosis?
ITB syndrome
Your patient was tackled playing football and hear a pop in their knee. + Lachmans, +valgus test and + Apley compression test. What’s the most likely diagnosis?
Terrible triad, O-Donoghue’s triad
ACL, MCL, medial meniscus
