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4 knee assessment - History

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Assessment of Knee joint

Published in: Health & Medicine
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4 knee assessment - History

  1. 1. Saurab Sharma, MPT Knee Joint Assessment Lecture 4 Subjective examination Objective examination Observation Palpation Range of motion Muscle length Muscle strength Reflex
  2. 2. Knee Joint Assessment Subjective Assessment Demographic data Chief complaint History of present illness
  3. 3. Objectives of knee assessment At the end of the day, students will be able to:  Understand the need of taking consent for assessment  Identify and ask relevant history question in knee injuries/ pain 3
  4. 4. Assessing a knee joint Components of the assessment include  Focused history  Attentive physical examination and  Thoughtfully ordered tests/studies 4
  5. 5. Subjective Assessment
  6. 6. Demographic data  Name  Age  Gender  Dominance  Address  Occupation 6
  7. 7. Chief complaint In patient’s own word  Pain  Swelling: immediate, delayed  Giving way  Locking  Deformity  Functional difficulty 7
  8. 8. History of present illness:  Onset of Pain  Date of injury or when symptoms started  Gradual/ sudden  Progression: getting better, getting worse, no change  Location of pain  Anterior  Medial  Lateral  Posterior 8
  9. 9. History of present illness: Mechanism of Injury -helps predict injured structure  Contact or noncontact injury?  If contact, what part of the knee was contacted?  Anterior blow?  Valgus force? (common)  Varus force?  Was foot of affected knee planted on the ground? (Closed vs open chain injury)9
  10. 10. History of present illness:  Bony avulsion  Slow developing force might  Ligament tear Rapidly developing force  MCL injury Valgus force  LCL injury  Varus force 10
  11. 11. History of present illness: ACL injury  Common in weight bearing, slight flexion and rotation in either directions  Anterior translatory force on proximal tibia  Hyperextension injury  Hyperflexion in bulky lower extremity muscles Meniscal injury  Twisting force (injury with rotation of the tibia) in weight bearing with slightly flexed knee  Medial meniscus more commonly injured than lateral 11
  12. 12. History of present illness:  PCL injury  Posterior translation of Tibia  Pretibial trauma (Dashboard trauma)  Hyper flexion (in thin individual)  Hyperextension (second ligament to be injured after ACL) 12
  13. 13. History of present illness:  These forces may cause injury to more than one structure and same structure may be damaged with various other kinds of mechanism of injury 13
  14. 14. History of present illness: 14
  15. 15. History of present illness: 15
  16. 16. History of present illness: 16
  17. 17. History of present illness: 17
  18. 18. History of present illness: Any clicking or pop sound during injury?  Indicates ligament tear (mainly ACL) in knee joint Any “give way” or “catch”?  give way= instability  Catch (lock)= meniscal injury 18
  19. 19. History of present illness:  History of Swelling?  Was the swelling immediate or delayed?  Synovial swelling takes 8-24 hours to develop  Haemarthrosis  Immediate swelling 19
  20. 20. History of present illness:  Site of swelling?  Area of swelling?  Localized swelling Extracapsular injury  Generalized swelling Intracapsular injury  Inflammed bursae? 20
  21. 21. History of present illness (HOPI):  History of type of shoes patient normally uses?  Flat shoes?  High heels?  Duration of usage of shoes?  Functional ability of the patient?  Any disability in running, climbing stairs etc21
  22. 22. History of present illness (HOPI): Sports specific history:  Total duration of play  Total practice/training session  Exercise protocol- warm up/ cool down  Competition 22
  23. 23. Summary: 23
  24. 24. Plan for next class  Pain assessment  Observation  Prerequisites:  Pain assessment  Observation 24

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