knee pain Flashcards
differential for knee pain
patellofemoral syndrome dgenerative joint dis patellar tendonitis MCL/LCL strain or tear meniscal tear ACL strain or tear
patellar dislocation (uncommon) fracture (common)
pop heard in the knee
ACL tear
history: what to look for in knee pain
mechanism of injury
pop sound
locking
stiffness with inactivity and pain with weight bearing activity (DJD)
stiffness improved with few min activity (DJD)
Chronic knee pain is often assoc w
weak quadriceps musc from disuse, resulting in patellofemoral dysfxn or anterior knee pain
anterior knee pain
catch all term that includes common conditions such as patellar tedonitis, patellofemoral dysfxn, and chrondromalacia patellae
inability to bear weight of knee indicates
internal derangement but not specific for any one injury
pts w degen joint dis often complain of
stiffness with inactivity, pain with weight bearing activity
Ottawa knee rules
get XR knee if pt has any of following: age 55 or older, tenderness at head of fibula, isolated patella tenderness, inability to flex to 90 deg, inability to bear weight
presence of ecchymosis and onset of swelling in
hemarthrosis over effusion (70% of knee injuries w hemarthrosis are ACL tears)
joint line tenderness
palpation on medial and lateral side for tenderness
McMurray’s test susggests
meniscal tear if get palpable click
imaging should be reserved for
those who fail to respond to therapy or if diagnosis is in doubt
reasons to refer for further eval or for surgery
hemarthrosis or rapid fluid accumulation, ACL or meniscus tears, third degree collateral ligament injuries, severe functional impairment, uncertainty about diagnosis, poor response to conservative tx
initial management of meniscal tears
rest and protected weight bearing with short course of PT usually
management of anterior knee pain
analgesics, quadriceps strengthening exercises, patellar taping, and ice
