Patient Presentation - Knee Flashcards
why are the rates of knee problems increasing?
ageing population
increasing rates of obesity
what are the common presentations of knee pain?
pain (often anterior and localised) stiffness swelling limp giving way deformity loss of sleep loss of function
important parts of knee pain history?
how pain/loss of function affects patient (as very subjective)
previous injury/surgery?
consider hip pain
what do you look for on knee examination?
deformity
gait
swelling
scars
what do you feel for on knee examination?
bony landmarks tenderness effusion stability get patient to show you where its sore patellar apprehension test
what movements do you assess in knee examination?
extension (not full extension = locked knee)
flexion
quads strength
how do you investigate knee pain?
usually none needed X ray MRI (if suggestion of meniscal tear) Plasma viscosity urate (gout)
how is knee pain managed generally?
explanation keep mobile support (sometimes) appropriate foot where NSAIDs (short term) analgesia physiotherapy referral surgery = last resort
common causes of knee pain?
ligament strain (often MCL)
bursitis
Osgood schattler’s
osteoarthritis (patella-femoral > knee)
rarer causes of knee pain?
chondromalacia patellae meniscus injury cruciate damage gout rheumatoid arthritis patellar arthritis patellar subluxation/dislocation
what is Osgood schlatters?
apophysitis at the tibial tubercle
inflammation of the patellar ligament at the tibial tubercle
know presentations of different ligament injuries
…
are knee replacements cemented or uncemented?
cemented
what is the most common reason for a knee replacement?
arthritis
how does a knee replacement compare to a hip replacement in terms of satisfaction?
not as successful as hip replacements
helps pain but not stiffness
