Flashcards in Lecture 6 Deck (69)
What is knee tendonitis?
Extensor mechanism tendinitis is an overuse injury involving either
(Above or below)
Who is prone to knee tendonitis?
Adults < 40 yrs who do jumping or kicking sports
Adults >40 yrs after change in exercise level or substantial weight gain
Hallmark of knee tendonitis?
Anterior knee pain
Describe the pain for knee tendonitis
Anterior knee pain
Immediately after exercise
- Prolonged sitting
Climbing stairs, running, squatting or jumping makes it worse
PE for knee tendonitis will show?
TTP at quad or patellar tendon
Mild infrapatella bursa swelling
Loss of ROM secondary to pain (can be forced)
Quadriceps atrophy (chronic)
Diagnostic tests for knee tendonitis?
Radiograph: normal except:
- some chronic findings
- or w Osgood-schlatter disease
MRI reserved for recalcitrant cases
What will radiographs show with chronic tendonitis?
Heterotropic ossification at the upper or lower pole of patella
What will show on x ray with a PMH of Osgood-Schlatter disease for tendonitis pts?
Large ossicle from an unhealed tibial tuberosity apophysis
Treatment for knee tendonitis?
1. Control inflammation
2. Achieve full ROM
3. strength conditioning back to 90%
4. Agility drills/RTD
He really liked PRICES, what does it mean?
Some guy wanted to get known for something but didnt have anything good so he added protection/pain meds and support,strength/stretching to bookend RICE
What are some treatment adjuncts for knee tendonitis?
Excision of nonunited tibial tuberosity ossicle
What tendonitis pts get referred?
Possible rupture of extensor mechanism (refer ASAP)
Cases recalcitrant to non-operative management
What is patellofemoral pain?
Constellation of problems characterized by a diffuse aching anterior knee pain
What makes patellofemoral pain better and worse?
Increase in activity that places additional loads across patellofemoral joint
Not doing those things
Patellofemoral pain is secondary to?
Though it causes anterior knee pain ____ is not considered patellofemoral pain.
Misalignment (bad Q angle)
Chondromalacia patella is not the same as patellofemoral pain. Why?
Chondromalacia indicats that pathologic changes are present in the articular surface of patella
Not always the case here
Chondromalacia patella is aka?
Clinical symptoms of patellofemoral pain?
Diffuse aching anterior knee pain
- prolonged sitting (theater sign)
Maybe instability of retropatellar catching sensation
Does patellofemoral pain knee swell?
How should i examine my patellofemoral pain pts?
Watch them walk
Look at Alignment (genu valgum foot pronation (flat foot))
What if the patient’s patella point toward eachother while walking?
Increased femoral anterversion
May increase patellofemoral pain
What is patellar apprehension sign?
Indicates patellar instability
With the knee extended translate the patella laterally and then flex the knee 30%
Discomfort or “apprehension” is instability
Palpate patella for crepitus in ROM
X rays of the sunrise view of patella is diagnostic for patellofemoral pain if?
The patella is not in the femoral grove
Fancy words are:
Treatment for patellofemoral pain
Strengthening and flexibility
Modified quadricep exercises to avoid causing knee pain
Patellar pad or knee sleeve to isolate patella
Which way does the patella typically dislocate?
Commonly lateral dislocation
Predisposing factors for patellar instability
Shallow trochlear groove
Muscular imbalance (VMO)
Patellar instability can cause dislocations
What 2 ways do patellar dislocations present?
Transient dislocation (w spontaneous reduction)
How does patellar instability present?
Loss of motion
(Mimics ACL injuries)