Special questions for knee:
swelling
locking/catching
bucking/giving out
popping
Medial / Lateral Instabilities
assess:
MCL
Normal range of varus and valgus stress
0-30
Anterior instabilities asses:
ACL
Lachman
anterior drawer
Posterior instabilities
sag sign
posterior drawer
Meniscal lesions
bounce home
thessaly
Mcmurrays
Patellofemoral Disorders
Assess patellar mobility Apprehension test (lateral)
Ottawa Knee Rules
- Age > 55
- Tenderness at the head of the fibula
- Isolated tenderness of the patella during palpation
- Inability to flex the knee to 90 degrees
- Inability to bear weight immediately and upon ER evaluation
Meniscal Pathology Test Item Cluster
- History of catching or locking reported by the patient
- Joint line tenderness
- Pain with forced hyperextension (modified bounce home test)
- Pain with maximal passive knee flexion
- Pain or audible click with McMurray manuever
Ottawa Ankle Rules
bone tenderness at posterior edge or tip of lateral/medial malleolus
inability to bear weight
base of 5th
navicular
What is OA characterized by?
Degeneration of cartilage
Hypertrophy of bone
Two types of OA
primary
secondary
Primary
DIP, PIP, hip, knee, carpometacarpal joint of the thumb, MTP, cervical and lumbar spine
Secondary
sequela to articular injury (intra-articular vs extra-articular, acute vs chronic)
Signs and Symptoms of OA:
Insidious onset Articular stiffness Pain on motion Flexion contracture or varus deformity of the knee Limitation of motion Crepitus Joint effusion No systemic manifestations
Imaging of OA
Narrowing of the joint space Osteophyte formation Lipping of marginal bone Thickened, dense subcondral bone Bone cysts
NSAIDS:
pain relief
fever relief
anti inflammatory
anticoagulant
