MSK hip, knees and feet

Question 1

In what position do you assess the patient for hip examination?

Answer 1

Both standing and sitting down

Question 2

What are you looking for when patient is standing in hip examination?

Answer 2

Muscle atrophy and bulking

Question 3

What are you looking for when patient is lying in hip examination?

Answer 3

Flexion deformity
One leg longer than other (measure)
scars

Question 4

What bony landmark are you measuring from for the length of the leg?

Answer 4

ASIS to medial malleolus

Question 5

What bony landmark are you feeling for in hip examination?

Answer 5

Greater tronchanter and surrounding muscles

Question 6

What movements do you do in hip examination?

Answer 6

flexion
Internal and external rotation
Thomas test
Trendelenburg’s test

Question 7

What is Thomas test looking for?

Answer 7

A fixed flexed deformity

Question 8

What is Trendelenburg’s test looking for?

Answer 8

Proximal gluteal muscle strength

Question 9

If their is positive tranderlengurgs test what does that indicate?

Answer 9

Weak hip abductor muscle to the contralateral side of the pelvis

Question 10

In function what are you assessing for in hip examination?

Answer 10

Gait

Question 11

What two gaits are you looking for in function part of hip examination?

Answer 11

Antalgic (painful) gait and trandelengurg’s (waddle) gait

Question 12

What are you looking for anterior when the patient is standing in knee examination?

Answer 12

Scars
Rash --> psoriasis 
Effusion
Quadriceps wasting
valgus and varus deformity 
Asymetery

Question 13

What are you looking for side on when the patient is standing in knee examination?

Answer 13

Fixed flexion deformity

Swelling in the popliteal area

Question 14

What are you looking for posteriorly on when the patient is standing in knee examination?

Answer 14

Scars
Rash --> psoriasis 
Effusion
Quadriceps wasting
valgus and varus deformity 
Asymetery
Popliteal swelling

Question 15

What is

a) valgus
b) varus deformity?

Answer 15

a) knocked knee

b) bowed leg

Question 16

When the patient is lying down what are you feeling for

Answer 16

Temperature 
Alignment of the knee for any tenderness and swelling
Popliteal swelling 
Patella tap 
Cross fluctuation

Question 17

What are you investigating in patella tap?

Answer 17

effusion

Question 18

If the patella tap is negative what other assessment do you do?

Answer 18

cross fluctuation test

Question 19

What landmarks are you palpating when you feel around the knee?

Answer 19

Femoral condyle
Inferior pole of the patella
Inferior patella tendon
Tibial tuberosity

Question 20

What movements do you assess in knee examination?

Answer 20

flexion and extension

Question 21

What are the special test?

Answer 21

Anterior and posterior draw test

Medial and lateral collateral ligament test

Question 22

What is the anterior and posterior draw test examination?

Answer 22

Anterior and posterior crucial ligaments respectively

Question 23

What does a positive anterior or posterior draw test indicate?

Answer 23

Anterior or posterior cruciate damage/laxity

Question 24

What are you looking for at the feet when the patient is lying down?

Answer 24

Nail changes
Rash
Swelling
Toe alignment --> halux valgus
Skin changes
Plantar aspect for callus formation

Question 25

What are you looking for at the feet when the patient is lying down? a) anterior b) posteriorly

Answer 25

a) weight bearing, arch of the foot, toe clawing | b) valgus or varus of the subtalar joint and Achilles tendon

Question 26

How do you assess the arch of the foot?

Answer 26

Ask the patient to go on tip toes and the downwards arch will disappear

Question 27

What do you feel in foot and ankle assessment?

Answer 27

Temperature Peripheral pulses Achilles tendon The joints in the foot and ankle

Question 28

What are the joints in the foot and ankle that you feel?

Answer 28

``` Gentally squeeze the MTP joints for pain Taral joints Ankle joint Subtalar joint Medial and lateral malleolus Proximal fibula ```

Question 29

What movements do you do actively and passively in the foot examination?

Answer 29

Foot dosiflexion, plantar flexion, inversion and eversion | Toe dorsiflexion, plantar flexion, abduction and adduction

Question 30

What extra joint do you move in passive movement in ankle?

Answer 30

Midtarsal joint movement

Question 31

What do you look for in gait in foot and ankle examination?

Answer 31

Heal lift, stance, toe off and full cycle

Question 32

What is the Ottowa Ankle Rule for acute kidney injury?

Answer 32

Palpate and ask if they have pain in the navicular, base of 5th metarsal and posterior aspect of the laterl/medial malleolus