Lower extremity clinical correlations

Question 1

What are the leg muscle compartments?

which is least likely to get exertional compartment syndrome?

Answer 1

4 compartments:

1. superficial posterior (soleus, gastroc)
2. deep posterior (tib post, FHL, FDL, popliteus)
3. anterior (tib ant, EHL, EDL, fib tertius)
4. lateral (fib longus, fib brevis)

superficial post is least likely because least compressed anatomically.

Question 2

SCFE

• hx
• etiology

Answer 2

slipped capital femoral epiphysis

• pain in groin and/or pain in knee/thigh (referred pain with obturator nerve).
• repetitive overload of joint. (classicaly overweight adolescent)

Question 2

transient synovitis of the hip

• epidemiology
• etiology

Answer 2

• ages 3-10
• etiology not completely understood; may be viral, post-vaccine or drug induced

Question 2

femoral acetabular impingement

Answer 2

-pain and reduced ROM in acetabulum because of extra bone growth on femur and/or pelvis

Question 4

Sever’s condition

Answer 4

• calcaneal apophysitis–inflammation at the growth plate of calcaneus
• caused by repetitive stress to the heel in growing children.
• explained by relative weakness of growth plate compared to tendon strength

Question 6

If you have loss of sensation between 3rd and 4th metatarsals, what is happening? what do you expect to see muscle-wise?

Answer 6

deep fibular nerve.

• innervates muscles in the ant compartment (tib ant, EHL, EDL, fib tert)
• Foot drop–loss of deep fib nerve

Question 7

septic joint

• etiology
• exam
• tx

Answer 7

1. gonorrhea or skin flora
2. swollen, painful joint. painful ROM
3. tx: surgical I+D, IV Abx

Question 8

how to test for meniscus tear?

Answer 8

mcmurray test–observe for click in knee associated with pain.

Question 9

transient synovitis of the hip

• exam findings
• tx

Answer 9

1. -child holds hip slight flexed and externally rotated
   - pain on hip motion
2. NSAIDs, 1-3 weeks