The Knee Flashcards
S&S of Ottawa Knee Rules
Age > 55
- Tenderness at head of fibula
- Isolated tenderness of patella
- Inability to flex knee to 90º
- Inability to walk 4 total weight-bearing steps (limping ok)
S&S of Pittsburgh Decision Rules
Blunt trauma of a fall as mechanism of injury plus any of the following
- Age <12 or >50 years old
- Inability to walk 4 total weight-bearing steps
S&S of Distal Femur Fractures
NWB x6 weeks
Very slow to heal (bony union at 4-6 months)
S&S of Knee Osteoarthritis
May have antalgic gait
Pain with weight-bearing/compression
May have history of previous knee trauma/overuse
S&S of MCL Tear
Swelling on medial side of the knee
Pain with extension
Tenderness to palpation
S&S of LCL Tear
Swelling on lateral side of the knee
Tenderness to palpation
S&S of ACL Tear
History of a ‘pop’ or giving way
Immediate swelling
S&S of PCL Tear
Limited swelling
S&S of Meniscal Injuries
Pain worse with movement, better with rest
Swelling appears ~24 post injury
S&S of PFPS
Pain with stairs
Pain with prolonged sitting
Sudden increase in activity/training
Tender to palpation under patella
S&S of Bursitis at the Knee
Due to excessive pressures or sudden incrase in activity level
Tightness in certain muscle groups
S&S of Patellar Tendinopathy
Palpation tenderness
Pain with knee extension AROM and resistance
S&S of a Plica
Can present similar to PFPS
May report snapping/popping sensation
Can be irritated during flexion or extension
AROM extension may be painful
Pain with medial glide of patella
S&S of ITB Syndrome
May complain of popping or crepitus
Sudden increase in activity level
AROM knee flexion may be painful
Tender to palpation
Weak glut. med.
Special Test for Distal Femur Fractures
Sign of the buttock
Special Test for Patellar Fractures
Sun-rise X-ray view
Special Tests for Segund Fractures
ACL tests
Hughston’s Drawer Sign
Special Tests for Knee Osteoarthritis
Compression and Distraction
Accessory motions
PROM/AROM
Special Test for MCL Tear
Valgus accessory motion in 20º knee flexion and full extension
Special Tests for ACL Tear
Anterior Drawer
- Also try with tibia IR, should have less movement if ACL is intact
Pivot-shift
Reverse Pivot-shift
Lachman’s
Special Tests for PCL Tear
Sag sign
Posterior Drawer
External Rotation Recurvatum test
Dial test
Special Tests for Meniscal Injuries
Four hallmark findings (better than MRI is all are positive)
- Joint line tenderness
- Mild to moderate effusion over 1-2 days
- Quad atrophy
- Positive entrapent test:
- Apley’s
- McMurray’s
- Thessaley’s
- Squat
Special Tests for PFPS
McConnell Test
Q-angle
Accessory motions
VMO coordination/activation test
Single leg squat, squat, & step down
Special Tests for Plica
Stutter test
Hughston’s Plica Test
Special Tests for ITB Syndrome
Ober’s test
Noble Compression test
