knee differentials Flashcards
PFPS symtoms?
anterior knee pain aggravated by prolonged sitting, stairs, kneeling
PFPS MOI?
gradual overuse injury
PFPS special tests?
overuse: eccentric step down test
movement coordination: single leg squat, lateral step down test
muscle: hipSIT, ABD, ER, EXT strength
hypomobility: patellar tilt, muscle length
PROM: pain at end range knee flexion
PFPS hip strengthen treatment?
bridges (can progress to single leg)
clams (progress)
fire hydrants
glute kickbacks (quadruped hip extension)
glute step downs
sidestep with resistance band
PFPS knee strengthen treatment?
quad set
short arc quads
WB (squats)- single leg
NWB (knee extensions)
PFPS differential diagnosis?
patellar tendonitis
OA
osgood schlatter
chondromalacia patella
plica syndrome
patellar tendonitis symptoms?
anterior knee pain aggravated by squatting, jumping
inferior pole of patella
15-50 year old
patellar tendonitis MOI?
gradual, repeated eccentric overloading during deceleration activities
patellar tendonitis special tests?
tests: declined single leg squat, royal london hospital test
PROM: pain end range knee flexion
patellar tendonitis isometric loading treatment?
knee extension machine
squat with strap
5 reps 45 seconds 2-3x a day
patellar tendonitis isotonic loading treatment?
squats
leg press
knee extension
want to progress to single leg
patellar tendonitis energy storage loading treatment?
plyometric loading
patellar tendonitis return to sport/activity treatment?
more sport specific
patellar tendonitis differential diagnosis?
ACL/PCL
PFPS
knee OA symptoms?
generalized knee pain aggravated by WB
knee OA MOI?
gradual due to micro or macrotrauma
knee OA special tests?
CPR:
1. knee pain
2. morning stiffness <30 mins
3. functional limitations
4. knee crepitus
5. knee restricted ROM
6. bony enlargements
capsular pattern: knee flexion less than extension
pain at end range knee flexion and extension PROM
knee OA treatment?
cyclic loading
quad strength
knee OA differential diagnosis?
disc herniation (L3/L4)
meniscus tear
tendonitis
hip pathology
knee fracture symptoms?
pain- night pain
knee fracture MOI?
trauma
knee fracture special tests?
ottawa knee rules
knee fracture acute treatment?
early AROM/PROM
heel slides
quad sets
knee fracture subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stair
knee fracture chronic treatment?
steamboats
lunges (onto bosu)
bosu ball squats (progress to single leg)
knee fracture differential diagnosis?
ACL, MCL, PCL, patellar dislocation
meniscus tear symptoms?
swelling, popping, clicking, pain along joint line, pain with hyperflexion/extension
swelling seen 6-24 hours after
meniscus tear MOI?
twisting injury while WB
medial torn more often
meniscus tear special tests?
McMurrays test
Thessalys test
meniscus tear acute treatment?
early
AROM/PROM
heel slides
quad sets
meniscus tear subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stairs
meniscus tear chronic treatment?
steamboats
lunges (onto bosu)
bosu ball squats (progress to single leg)
MWM squeeze technique
meniscus tear differential diagnosis?
ACL, MCL, OA, patellar dislocation, tibial plateau fracture
ACL tear symptoms?
popping or giving out
pain
immediate dysfunction
immediate swelling (0-2 hours)
instability
ACL tear MOI?
twisting or hyperextension of the knee
ACL tear special tests?
lachmans
anterior drawer
lelli lever
pivot shift
AROM/PROM (decreased knee extension)
ACL tear acute treatment?
early AROM/PROM
heel slides
quad sets
ACL tear subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stair
ACL tear chronic treatment?
steamboats
lunges (onto bosu)
bosu balls squats (progress to single leg)
ACL tear differential diagnosis?
PCL tear
PCL tear symptoms?
popping or giving out
pain
immediate dysfunction
immediate swelling (0-2 swelling)
instability
PCL tear MOI?
hyperextension
PCL tear special tests?
posterior drawer
posterior sag
AROM/PROM (decreased knee extension)
PCL tear acute treatment?
early
AROM/PROM
heel slides
quad sets
PCL tear subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stair
PCL tear chronic treatment?
steamboats
lunges (onto bosu)
bosu balls squats (progress to single leg)
PCL tear differential diagnosis?
ACL tear
MCL tear symptoms?
localized swelling/stiffness
medial pain and tenderness
MCL tear MOI?
valgus stress
MCL tear special tests?
valgus stress test
palpation
MCL tear acute treatment?
early
AROM/PROM
heel slides
quad sets
MCL tear subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stair
MCL tear chronic treatment?
steamboats
lunges (onto bosu)
bosu balls squats (progress to single leg)
LCL tear symptoms?
localized swelling/stiffness
lateral pain and tenderness
LCL tear MOI?
varus stress
LCL tear special tests?
varus stress test
palpation
LCL tear acute treatment?
early
AROM/PROM
heel slides
quad sets
LCL tear subacute treatment?
straight leg raises
short arc quads
wall squats
step ups/downs on stair
LCL tear chronic treatment?
steamboats
lunges (onto bosu)
bosu balls squats (progress to single leg)
ITB syndrome symptoms?
lateral knee pain diffuse and hard to localize
aggravated by climbing and descending stairs
history in changes in training surface, increased milage
tenderness at lateral femoral condyle/girdy’s tubercle
ITB syndrome MOI?
overuse
ITB syndrome special tests?
Obers test
nobel compression test
ITB syndrome treatment?
strengthen hip- sidelying leg raises, clams, standing SLR, steamboats
ITB stretches
ITB syndrome differential diagnosis?
lateral meniscus tear
lateral compartment OA
MCL tear differential diagnosis?
medial meniscus
ACL
tibial plateau fracture
PCL
patellar subluxation
LCL tear differential diagnosis?
ACL
tibial plateau fracture
PCL
patellar subluxation
lateral meniscus
hamstring strain symptoms?
pain in posterior leg
hamstring strain MOI?
eccentric use of hamstring
hamstring strain special tests?
SLR
90/90 hamstring goni
active knee extension test
hand held dynamometer
TTP distance from IT
hamstring strain acute treatment?
single leg balance
strengthen hips
balance board
hamstring strain subacute treatment?
hamstring curls
wall squats
squats (progress to single leg)
hamstring strain chronic treatment?
single leg squats on bosu ball
lunges onto bosu ball
nordic hamstring
box jumps (control descent)
hamstring strain differential diagnosis?
lumbar radiculopathy
deep gluteal syndrome
SI dysfunction
Adductor muscle strain
patellar dislocation symptoms?
anterior knee pain with WB
patellar dislocation MOI?
twisting injury with the femur IR on a fixed foot
could be no trauma
patellar dislocation special tests?
AROM/PROM
joint play
PFJ apprehension test (patellar tilt)
patellar dislocation treatment?
normalize gait (AD, heel slides-flexion)
patellar mobilization (medially)
quad sets
SLR
short arc quads
long arc quads
squat (can add bosu ball, weights)
SLS
patellar dislocation differential diagnosis?
PFPS
tendonitis