Knee Case Study Week 2: Difference between revisions
Michelle Lee (talk | contribs) (Created page with "== Referral == Right Knee pain 32 year old female == Subjective == === History of Presenting Condition === 6 months insidious onset right anterior knee pain,...") |
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== Referral == | == Referral from Physician == | ||
Right Knee pain 32 year old female | Right Knee pain 32 year old female | ||
== Subjective == | == Subjective == | ||
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=== History of Presenting Condition === | === History of Presenting Condition === | ||
6 months insidious onset right anterior knee pain, had an x-ray NAD | 6 months insidious onset right anterior knee pain, had an x-ray but nothing abnormal detected (NAD). Slowly getting worse, went to A+E with the pain 3/52 ago, diacharged 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 === | === Presenting Condition === | ||
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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 | |||
[[Category:Case Studies]] | |||
Latest revision as of 00:02, 12 March 2018
Referral from Physician[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 but nothing abnormal detected (NAD). Slowly getting worse, went to A+E with the pain 3/52 ago, diacharged 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
