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30 Cards in this Set
- Front
- Back
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pattelofemoral joint
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-articular surface b/t patella and trochlear groove
-gliding motion |
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recurvatum
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-hyperextension of knee
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meniscal test
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-mcmurray
-apply compression -reduction click |
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chondromalacia patella
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-teenage female most common
-degeneration of articular cartilage surface -Crepitus with ROM -quad weakness -aggrevated by squatting, prolonged sitting, ambulating down stairs -hypermobile patella -painful compression test |
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Chondromalacia Patella dx and tx
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-Dx: xray --> lateralization/patella tilt on merchant view
-Tx: activity modification, NSAIDs. PT, brace, quad stregthening, ride bike with seat up high |
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Patella subluxation
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-tight lateral retinaculum
-residual from chronic dislocations -females -buckling sensation -apprehension test + (push on medial border of patella) -tender lateral compartment |
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patella subluxation dx and tx
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-Dx: xray --> patella alta, shallow trochlear groove
-Tx: strenghtening, lateral release, proximal patella realignment, brace |
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patella dislocation
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-lateral most common
-direct medial trauma -acute pain -patella displaced -effusion -apprehension tst -ant medial pain -knee flexed |
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patella dislocation- dx and tx
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-Dx: xray--> lat displaced patella on AP
-Tx: reduction with knee extension hip flexion; straight leg immobilizer for 3 wks -PT |
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Patella tendonitis
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-jumpers knee
-inflamm of tendon -overuse injury -point tenderness -pain with resisted ext -inc with jumping, sqatting, climbing -swelling -Tx: RICE, chopat strap, NSAIDS |
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Quadriceps Tendon/Patella Ligament Rupture
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-tearing of musculotendonious junction/ligament
-partial vs complete -avulsion fx? -athlete steroids? -overwt -pain/swelling -palpable defect -inability to extend knee SLR |
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Quadriceps Tendon/Patella Ligament Rupture- Dx and Tx
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-Dx: xray--> evidence of avulsion fx
MRI --> conformation test of choice -Tx: conservative casting 8-12 wks, surgical repair |
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osgood-schlatter
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-irritation of apophysis of tibial tubercle
-traction/stress from patella tendon -hypertrophy of tubercle/calcific densities loose bodies -male adolescents/athletes -localized pain/swelling over tibial tubercle inc with jumping, climbing, running, ext -painful limb |
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Osgood-Schlatter- dx and tx
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-Dx: xray --> fragmentation of tubercle
-Tx: rest. ice, NSAIDs. activity modification, PT, stretching, Surgical excision of fragments at maturity if painful |
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prepatellar bursitis
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-inflamm of bursa- can get infected
-repetitive trauma (kneeling) -soft, non-tender, fluctuant, no joint involvement!! -infective/gout- extremely tender, red, assoc wounds, joint involvement |
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prepatellar bursitis- dx and tx
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-Dx: aspiration
-Tx: inflamm --> aspiration, steroid, activity mod infective --> aspiration, abx, I&D gout--> indocin |
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pes anserine bursitis/tendonitis
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-inflamm of pes anserine insertion/bursa
-overwt./runners -pain at rest/night -medial pain lower than joint line -local tenderness, swelling -Tx: ice, NSAIDs, steroids |
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Osteochondritis Dessicans
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-lose of vascularization of sub-chondral bone
-medial femoral condyle most common -fragmentation -often bilateral -M>F -ongoing pain -night pain! -inc with activity -point tenderness -effusion -painful gait |
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Osteochondritis Dessicans dx and tx
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-Dx: xray lucency of defects, loose bodies
-MRI higher sensitivity -Tx: observation/protect wt bearing status -scope chondroplasty, grafting |
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osteonecrosis
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-infx
-alcohol -steroids -gout ->50 yrs -insidious progression -effusion, local tenderness -antalgic gait |
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Osteonecrosis- dx and tx
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-Dx: xray radiolucency of lesions; bone scan inc uptake; MRI
-Tx: protect wt bearing status, NSAIDs. total arthroplasty |
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Condyle and Tibial Plateau Fractures
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-blunt, joint loading trauma
-disruption of cortical bone -swelling, inability to wt bear -intense pain -local point tenderness -effusion -deformity -ecchymosis |
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Condyle and Tibial Plateau Fractures dx and tx
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-Dx: xray --> disruption of cortical bone, fragmentation loose bodies
CT --> inc bone detail MRI --> assoc soft tissue -Tx: conservative, if >2mm needs to be operated on1! |
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Medial and Lateral Collateral Ligament Injuries
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-athletes
-twisting injury- foot is planted and hit on contralat side -medial/lat pain -swelling -instability -local tenderness -min-mild effusion -ecchymosis |
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Medial and Lateral Collateral Ligament Injuries dx and tx
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-Dx: xray --> assoc fx
MRI --> ligament disruption -Tx: RICE, derotational hinged brace, PT, surgery |
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Menisci Tears
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-twisting injury with planted foot
-medial>lat -post>ant horn -joint line tenderness! -effusion (5 hrs later) -+ mcmurry, apley compression test |
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menisci tears dx and tx
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-Dx: MRI
-Tx: RICE, PT, NSAID. arthroscopy with menicectomy, repair of peripheral tears |
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Anterior Cruciate Ligament Tears
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-violent twisting injury with planted foot
-swell imediately! -painful pop! -ant displacement of femur on tibia -often assoc with medial meniscus and MCL tears = triad of o'donohue or unhappy triad! -instability -+lachman, pivot shift, ant draw |
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ACL tears dx and tx
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-Dx: MRI--> confirm dx; aspiration --> hemarthrosis
-Tx: PT, brace, surgical reconstruction with intensive PT 4-6mo (young, athletes, chronic instability) |
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PCL tears
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-hyperextension injury
-violent ant displacing force -instability -ant knee pain -mild effusion -+ post sag sign, post draw -Dx: MRI -Tx: PT |
