Physical Examination of the Leg Flashcards
Several underlying conditions that contribute to leg pain
bone stress
vascular insurficenct
inflammation
compartment sydrome
nerve entrapment
Bone stress Pathology types
normal remodel
accelerated remodelling
stress reaction Grade 1,2,3,4
fractured/ completed
medial tibia stress syndrome
inflammatory, traction phenomena on medial tibia
the posterior muscle on the tib are pulling too much
because of tibial bending// soft tissue traction off deep flexors
MTSS risk factors
increased external hip rotation
prior use of orthotics
females
increased BMI
navicular drop
increased ankle plantarflexion ROM
MTSS patient exam
diffuse pain along medial tibial border
usually warms up with activity
worse next day post exercise
MTSS score system
pain at rest
pain while ADL
limitations in sport
pain in sport
MTSS physical exam
navicular drop
AROM/PROM decrease hip internal rotation/ increased external hip rotation
palpation- tibial tendernous
Tibial stress fractured
is very localised pain in leg
along the tibial
constant pain
exercise aggrevates
tibial stress fracture physical exam
localised tenderness
special test- positive hop test
chronic exertional compartment syndrome
-increase in pressure within a closed fibrosseous space
decrease blood flow and tissue prefusion
ischaemic pain damage to tissue
CECS patient description
ache, tight, bursting
motor weakness
absense of pain at rest
increase pain and tight when exercise
CECS physical exam
must refer to GP
muscle tightness
muscle bulge/ hernia
decrease pulse
intracompartmental pressure test
periosteal contusion
bone bruise
direct blow by hard object
serve pain at time of injury
persistant pain
local tenderness/ bony swelling
acute fracture
inability to weight bear if displaced
fracture may be visible
nerve entrapment
peroneal nerve in lateral compart
deep peroneal in anterior compart
sensory changes
motor changes
leg pain not to be missed
tumours- night pain, chronic pain, weight loss, loss of appetite
infection- fever, redness
DVT
calf muscle strain pt interveiw
sharp stabbing pain
tearing sensation
MOI- acceleartion
palpate tenderness
pain with active PF
calf raise, hop
loss of DF ROM
DIAGNOSIS of gastroc or soleus
Use knee flexion to differntiate
DOMS
unaccustomed high intensity exercise
excessive eccentric muscle contraction
Leg and calf pain Due to pain from spine
AROM lumbar spine
pain/ stiff in low back
aggreviating- low back movements
lumbar quadrant test
Calf pain vascular entrapment
popliteal artery
pain worse with exertion
pulse deminished
doppler ultrasound will confirm
refereal to GP
DVT
constant pain
tenderness
increased temp
diffuse swelling
recent immobilisation
bedridden
recent paralysis
cancer
calf swollen
