Knee Case Study Week 2: Difference between revisions
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*Started the gym 8 months ago to lose weight, liked doing high intensity interval training classes - stopped now due to knee pain <br> | *Started the gym 8 months ago to lose weight, liked doing high intensity interval training classes - stopped now due to knee pain <br> | ||
== Objective == | == Objective == | ||
'''Observation''' | |||
*No visible swelling to the joint | *No visible swelling to the joint | ||
*Gait - nil significant <br> | *Gait - nil significant <br> | ||
Active range of movement:<br> | '''Knee''' | ||
Active range of movement (AROM):<br> | |||
*Flexion full | *Flexion full | ||
*Extension full | *Extension full | ||
Passive range of movement:<br> | Passive range of movement (PROM):<br> | ||
*Full slight discomfort normal soft end feel | *Full slight discomfort normal soft end feel | ||
*Extension - + 10 degrees of hyperextension soft end feel slight discomfort | *Extension - + 10 degrees of hyperextension soft end feel slight discomfort | ||
Resisted range of movement | Resisted range of movement:<br> | ||
*Flexion -5/5 no pain | *Flexion -5/5 no pain | ||
*Extension -5/5 increases sharp pain anterior knee | *Extension -5/5 increases sharp pain anterior knee | ||
'''Hip''' | |||
Active range of movement:<br> | |||
*Flexion full | *Flexion full | ||
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*ER ½ | *ER ½ | ||
Passive range of movement:<br> | |||
*Flexion - full | *Flexion - full | ||
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*ER ¾ tight end feel | *ER ¾ tight end feel | ||
Resisted range of movement:<br> | |||
*Flexion 5/5 | *Flexion 5/5 | ||
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*ER -5/5 | *ER -5/5 | ||
'''Special tests:''' | |||
*MCL/ LCL/ ACL/ PCL stress testing -ve | |||
'''Palpation:''' | |||
*Palpation medial and lateral joint line not painful | *Palpation medial and lateral joint line not painful | ||
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*Palpation patella tendon reproduces sharp pain. | *Palpation patella tendon reproduces sharp pain. | ||
'''Functional tests:''' | |||
*squat = decreased weight bearing on right leg, adduction of right leg more than left on squat increases right anterior knee pain |
Revision as of 11:38, 14 November 2016
Referral[edit | edit source]
Right Knee pain 32 year old female
Subjective[edit | edit source]
History of Presenting Condition [edit | edit source]
6 months insidious onset right anterior knee pain, had an x-ray NAD
Slowly getting worse, went to A+E with the pain 3/52 ago d/c with advice on taking paracetamol and naproxen regularly. Went to the GP as pain not easing and finding it difficult to cope with pain. GP referred to Physiotherapy
Presenting Condition[edit | edit source]
- Pain anterior knee - constant dull ache 4/10 which increases to 8/10 sharp intermittent pain when walking down stairs or squatting, can hear knee cracking on flexion / extension occasionally.
- Diurnal pattern activity dependent
- Aggravated by walking up and down stairs, walking for more than 30 mins, wearing heels for work, standing after sitting at work for a long time. Driving
- Eased: Not much, Paracetamol take the edge off
- Not waking at night
- No locking / clicking / giving way
Past medical History [edit | edit source]
Asthma - controlled not using inhalers now, cesarean section 2 years ago for birth of child
Drug History [edit | edit source]
Paracetamol PRN, Oral Contraception
Social History[edit | edit source]
- Full time office worker
- Has 2 year old son
- Lives with husband
- Started the gym 8 months ago to lose weight, liked doing high intensity interval training classes - stopped now due to knee pain
Objective[edit | edit source]
Observation
- No visible swelling to the joint
- Gait - nil significant
Knee
Active range of movement (AROM):
- Flexion full
- Extension full
Passive range of movement (PROM):
- Full slight discomfort normal soft end feel
- Extension - + 10 degrees of hyperextension soft end feel slight discomfort
Resisted range of movement:
- Flexion -5/5 no pain
- Extension -5/5 increases sharp pain anterior knee
Hip
Active range of movement:
- Flexion full
- Extension neutral
- IR ½
- ER ½
Passive range of movement:
- Flexion - full
- Extension + 5 from neutral tight end feel especially with knee flexion
- IR ¾ tight end feel
- ER ¾ tight end feel
Resisted range of movement:
- Flexion 5/5
- Extension -5/5
- IR 5/5
- ER -5/5
Special tests:
- MCL/ LCL/ ACL/ PCL stress testing -ve
Palpation:
- Palpation medial and lateral joint line not painful
- Patella slight stiffness into medial and lateral glide
- Palpation quadriceps tendon no pain
- Palpation patella tendon reproduces sharp pain.
Functional tests:
- squat = decreased weight bearing on right leg, adduction of right leg more than left on squat increases right anterior knee pain