Patient Presentation: Hip and Knee Flashcards
name the components of the NERDS mnemonic for the types of MSK pain patients present with
N: night pain E: exercise related pain R: referred pain D: discomfort S: stiffness
what should you be looking for on examination?
deformity
asymmetry
scars
what should you be feeling for on examination?
swelling
bony landmarks
tenderness
heat
what should you be looking for on the patient’s movement?
range of movement
stiffness
pain on moving
does heat indicate a superficial or deep problem?
superficial
when should you do an x ray on someone with pain?
only if it affects your management of the patient
what would you suspect in a patient with a short, externally rotated leg after a fall?
fracture of the neck of the femur
what management other than drugs is used in patients with pain?
OT education weight management walking stick physio mobility assistance
1st, 2nd and 3rd line medical treatment for OA?
1) analgesics
2) NSAIDs/hydrotherapy
3) surgery
most common causes of hip pain?
OA RA seronegative arthritis fracture referral from back malignancy
rarer causes of hip pain?
soft tissue problem
paget’s disease
infection
avascular necrosis
what is the minimum age that a total hip replacement is deemed to be properly effective?
60+
what are some common consequences of a knee injury?
locking instability clicking catching swelling
where does hip pain tend to radiate to?
groin
where does back pain tend to radiate to?
buttocks
what should be done if the patient gets an infection from a joint replacement?
take it out for 3 months and reinsert
gold standard type of THR?
metal on polyethylene
what does the ACL do?
prevents anterior translation of the tibia
prevents excessive internal rotation of the tibia
tests for ACL?
lachmann’s
anterior drawer
pivot shift
what structure can be injured if the knee gives way following an injury?
menisci
can you repair an ACL rupture?
no, can only reconstruct
name the 3 types of tendon graft used in ACL reconstruction?
autograft
allograft
synthetic graft
