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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Revision as of 20:56, 24 October 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]
- No visible swelling to the joint
- Gait - nil significant
Active range of movement:
Knee -
- Flexion full
- Extension full
Passive range of movement:
Knee -
- Full slight discomfort normal soft end feel
- Extension - + 10 degrees of hyperextension soft end feel slight discomfort
Resisted range of movement
Knee
- Flexion -5/5 no pain
- Extension -5/5 increases sharp pain anterior knee
Active range of movement:
Hip -
- Flexion full
- Extension neutral
- IR ½
- ER ½
Passive range of movement:
Hip -
- 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:
Hip -
- Flexion 5/5
- Extension -5/5
- IR 5/5
- ER -5/5
MCL/ LCL/ ACL/ PCL stress testing -ve
- 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 - squat = decreased weight bearing on right leg, adduction of right leg more than left on squat increases right anterior knee pain