Knee evaluation

Evaluación rodilla
Knee Evaluation
 
The following outline will serve as a guide for examinations
History
1. When did the injury occur?
2. How did it happen? (etiology)
a) were you planted?turned/twisted?
b) did someone hit you?
c) did you hear anything? pop? crack? grinding?
d) did it occur during a game or practice?
e) what was the playing surface like? wet/dry?
f) what type ofpain is the patient experiencing ?
where, when, sharp, aching
dull, aching pain is usually indicative of degenerative
intra articular pain.
g) did the knee swell and if so, did the swelling occurfairly rapidly over a 6-8 hour period (ACL) or did it take several days to swell. (meniscus)
Observation
2. what functional limitations does the patient have ?
running
cutting
pivoting
twistingclimbing or descending stairs
3. Previous history of injury to that area?
4. Sight/visual evaluation
a) swelling? Is it extra capsular or intra articular ?
intraarticular = ACL, meniscus.extra-articular = bursae, MCL - LCL ligament tears
b) deformities?
c) discoloration? not a common finding
d) quad tenses (bilateral) - full extension? apprehensive?
5. Palpation evaluation
a) feel forheat - hemarthrosis, blood in the joint is hotter than synovial fluid
b) check patellar movement - medial, lateral, proximal, and distal check for tendencies of patellar apprehension or subluxation
c)check palpable painful sites, i.e.., medial and lateral joint lines, ligament attachment sites
6. Stress tests
Ligamentous instability
one plane medial
one plane lateral
one plane anteriorly
oneplane posteriorly
anterior medial rotary
anterior lateral rotary
posterior medial rotary
posterior lateral rotary
|Always test the normal side first, apply the stress firmly but ||
|gently feel for the ligament end point. The muscle must be | |
|relaxed. ...