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5b observation of Knee Joint

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This powerpoint is intended to give an overview of observation of knee to undergraduate first year students. Students should not forget to do overall comprehensive observation of posture and other body parts before focusing the observation locally at the knee joint.

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5b observation of Knee Joint

  1. 1. Saurab Sharma, MPT Knee joint assessment Observation Skills
  2. 2. Objectives of session At the end of the class, students will be able to:  Understand the concept of dominant eye  Identify various positions and views for observation  Identify the Key Points in Observation of a body part  Identify observational characteristics of common disorders of knee joint 2
  3. 3. Observation VIEWS FOR OBSERVATION?  Standing  Anterior view  Posterior view  Lateral view  Sitting (anterior and lateral view)  Lying down (supine, side-lying, prone) 3
  4. 4. Observation:  Patient should be exposed to see knee joint and a joint proximal and distal to it (i.e. Hip and ankle joint)  Key points: 1. Consent 2. Adequate explanation about the necessity of exposure during patient assessment and its benefit during the treatment 3. Confined place or environment to maintain patient’s privacy 4
  5. 5. Observation: Anterior View (Standing) General observation:  Built  Facial expressions  Posture  Guarding/ splinting  Extra devices/ external appliances  Gait 5
  6. 6. Observation: Anterior View (Standing)  Observe for knee joint alignment  Genu valgum  Lateral angle less than 170°  Genu varum  Lateral angle more than 180°  Children at age of 18-19 months: genu varus which is normal  Age 3-4 years: knee attains valgum  Adults have 5-10° of genu valgum6
  7. 7. Observation: Anterior View (Standing)  Swelling?  Localised Extracapsular  Entire joint Intracapsular  Quadriceps wasting?  Disuse atrophy?  Quadriceps inhibition?  Position of patella?  Squinting of patella medially facing patella 7
  8. 8. Observation: Lateral View (Standing)  Any Discoloration? Bruising? or abrasion? Scar?  Knee alignment  Genu recurvatum?  Hyperextension of knee more than 10° 8
  9. 9. Observation: Lateral View (Standing)  Position of patella?  Patella Alta Abnormal high position of patella  Patella Baja Abnormal low position of patella  Alignment of other joints like ankle, hip and lumbar spine  Lordosis of spine is associated with hyper- extension of the knee and plantar flexion at the ankle 9
  10. 10. Observation: Posterior View (Standing)  As Anterior view  Any abnormal swelling? Baker’s cyst 10
  11. 11. Observation: In sitting (Lateral & anterior View)  Observe for Position of the patella.  Patella should face forward and should rest on the distal end of the femur  In Patella Alta Patella rest in the anterior surface of the femur  Frog Eyes patella or Grasshopper Patella Patella face upward and outward away from each other 11
  12. 12. Observation: In sitting (Lateral & anterior View)  Note for any tibial torsion. Excessive tibial torsion may cause:  Chondromalacia patellae  Patellofemoral instability  Enlarged tibial tubercle?  Osgood Schlatter disease 12
  13. 13. Observation: 13
  14. 14. Observation: 14
  15. 15. Summary: 15
  16. 16. Plan for next class  Palpation of knee  Prerequisites:  Knee surface marking  Stanley Hoppenfield’s book on Physical examination 16

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