The document provides an overview of the anatomy of the knee, including the bones, ligaments, tendons, cartilage, and bursae. It then discusses common causes of acute and chronic knee pain such as injuries to the ACL, meniscus, and tendons. It outlines treatments for various conditions including PRICE therapy, surgery, and rehabilitation. The document emphasizes the importance of maintaining a healthy weight and lifestyle to prevent knee problems through exercises, stretching, and limiting high-impact activities.
Medical aspects of buttocks (gluteus maximus,gluteus medium,gluteus minimum)martinshaji
luteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips.The gluteus maximus straighten the leg at the hip; when the leg is flexed at the hip, the gluteus maximus extends it to bring the leg into a straight line with the body.This study details about the anatomy, functions,clinical presentations , diseases associated,pain on the buttock region.
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nursing intervention for patients with musculoskeletal system disorders by Mulugeta Emiru (MSc in Adult health Nursing): Mizan Tepi university. 2017/2018.
Medical aspects of buttocks (gluteus maximus,gluteus medium,gluteus minimum)martinshaji
luteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips.The gluteus maximus straighten the leg at the hip; when the leg is flexed at the hip, the gluteus maximus extends it to bring the leg into a straight line with the body.This study details about the anatomy, functions,clinical presentations , diseases associated,pain on the buttock region.
please comment
thank u
nursing intervention for patients with musculoskeletal system disorders by Mulugeta Emiru (MSc in Adult health Nursing): Mizan Tepi university. 2017/2018.
A number of periarticular disorders have become increasingly common over the past two to three decades, due in part to greater participation in recreational sports by individuals of a wide range of ages. Periarticular disorders most commonly affect the knee or shoulder. With the exception of bursitis, hip pain is most often articular or is being referred from disease affecting another structure.
Tendonitis details and it's physiotherapy management.
It is define as inflammation of the tendon, tendonitis occur due to overuse and trauma. Depending upon involvement of tendon special test are used. it is treated with PRICE protocol.
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
Knee pain treatment approaches will vary, relying upon what precisely is inflicting your knee ache. Your physician can also additionally prescribe medicinal drugs to assist relieve aches and dealing with the situations inflicting your knee ache, inclusive of rheumatoid arthritis or gout. Find more info here: https://philaholisticclinic.com/knee-pain-treatment/
A number of periarticular disorders have become increasingly common over the past two to three decades, due in part to greater participation in recreational sports by individuals of a wide range of ages. Periarticular disorders most commonly affect the knee or shoulder. With the exception of bursitis, hip pain is most often articular or is being referred from disease affecting another structure.
Tendonitis details and it's physiotherapy management.
It is define as inflammation of the tendon, tendonitis occur due to overuse and trauma. Depending upon involvement of tendon special test are used. it is treated with PRICE protocol.
This short presentation is to help those in medical fields to have a summary knowledge of what bursitis is and it can also help students in their assignments and or course works. It contains what bursae are, what bursitis means, causes, risk factors, common sites, clinical features, how to diagnose bursitis, other conditions that can mimic bursitis, how to prevent bursitis and management.
Knee pain treatment approaches will vary, relying upon what precisely is inflicting your knee ache. Your physician can also additionally prescribe medicinal drugs to assist relieve aches and dealing with the situations inflicting your knee ache, inclusive of rheumatoid arthritis or gout. Find more info here: https://philaholisticclinic.com/knee-pain-treatment/
Global Medical Cures™ | What are Knee Problems ?
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Do you find any or such kind of problems in your bones or joints, then just book an appointment with a well qualified and experienced doctor in Delhi NCR at http://www.credihealth.com
The knee is prone to injuries like ACL tears, meniscus tears, and patellar tendinitis. ACL tears often require surgery and extensive rehabilitation, while meniscus tears can be treated with physical therapy or arthroscopic surgery. Patellar tendinitis is typically managed with rest, physical therapy, and anti-inflammatory medications. Knee clinics offer specialized care for these injuries, with knee specialists providing accurate diagnosis and personalized treatment plans to facilitate prompt recovery and long-term joint health.
The knee is prone to injuries like ACL tears, meniscus tears, and patellar tendinitis. ACL tears often require surgery and extensive rehabilitation, while meniscus tears can be treated with physical therapy or arthroscopic surgery. Patellar tendinitis is typically managed with rest, physical therapy, and anti-inflammatory medications. Knee clinics offer specialized care for these injuries, with knee specialists providing accurate diagnosis and personalized treatment plans to facilitate prompt recovery and long-term joint health.
For more information about knee sprains, watch this presentation. Here you will find four ligaments in the knee joint, any of which can be sprained.
URL:- www.metrophysio.co.uk
Ligament Injuries - Types, Symptoms and TreatmentHealth Quest
Ligament injuries occur when a ligament is stretched beyond its normal range. Ligaments are tough band of fibrous tissues that connects bone to bone or bone to cartilage and support, stabilize and strengthen joints. The primary function of ligaments is to keep the bones in proper alignment and prevent abnormal joint movements. Leading pain management centers in Brooklyn, NYC offer effective treatment options for ligament injuries to help patients attain better mobility, balance, and strength.
Strategic business proposal eent - green brick project - arunesh chand mank...Consultonmic
Strategic Project to Set up One of the largest Fly Ash Bricks Industrial Area in the world. All the the technical & financials are on actual FY- 2014-15 .
All rights reserved to Arunesh Chand Mankotia
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Knee Pain Overview
Knee pain is the most common musculoskeletal
complaint that brings people to their doctor. With
today's increasingly active society, the number
of knee problems is increasing. Knee pain has a wide
variety of specific causes and treatments.
Anatomy of the Knee
The knee joint's main function is to bend, straighten,
and bear the weight of the body along with
the ankles and hips. The knee, more than just a
simple hinged joint, however, also twists and rotates.
In order to perform all of these actions and to support
the entire body while doing so, the knee relies on a
number of structures including bones, ligaments,
tendons, and cartilage.
3. Bones
The knee joint involves 4 bones.
The thighbone or femur comprises the top
portion of the joint.
One of the bones in the lower leg
(or calf area), the tibia, provides the bottom
weight-bearing portion of the joint.
The kneecap or patella rides along the front of
the femur.
The remaining bone in the calf, the fibula, is
not involved in the weight-bearing portion of
the knee joint. It only provides ligament
attachments for stability.
4. Ligaments
Ligaments are dense fibrous bands that
connect bones to each other.
The knee includes 4 important ligaments, all of
which connect the femur to the tibia:
The anterior cruciate ligament (ACL)
and posterior cruciate ligament (PCL) provide
front and back (anterior and posterior) and
rotational stability to the knee.
The medial collateral ligament (MCL) and
lateral collateral ligament (LCL) located along
the inner (medial) and outer (lateral) sides of
the knee provide medial and lateral stability
to the knee.
5. Tendons
Tendons are fibrous bands similar to ligaments.
Instead of connecting bones to other bones as
ligaments do, tendons connect muscles to
bones.
The 2 important tendons in the knee are (1)
the quadriceps tendon connecting the
quadriceps muscle, which lies on the front of
the thigh, to the patella and (2) the patellar
tendon connecting the patella to the tibia
(technically this is a ligament because it
connects 2 bones).
The quadriceps and patellar tendons are
sometimes called the extensor mechanism,
and together with the quadriceps muscle they
facilitate leg extension (straightening).
6. Cartilage
Cartilaginous structures called menisci (one is a
meniscus) line the top of the tibia and lie between the
tibia and the 2 knuckles at the bottom of the femur
(called the femoral condyles).
The menisci's primary job is to provide cushioning for
the knee joint.
Bursae
Bursae (one is a bursa) are fluid-filled sacs that help to
cushion the knee. The knee contains 3 important
groups of bursae:
The prepatellar bursae lie in front of the patella.
The anserine bursae is located on the inner side of the
knee about 2 inches below the joint.
The infrapatellar bursae are located underneath the
patella.
7. Home Care for Knee Pain
Inflammation is the body?s physiologic response to
an injury. In treating many types of knee pain, a
common goal is to break the inflammatory cycle.
The inflammatory cycle starts with an injury.
After an injury, substances that cause
inflammation invade the knee, which causes
further injury, which leads to further
inflammation, and so on. This cycle of
inflammation leads to continued or progressive
knee pain. The cycle can be broken by controlling
the substances that cause inflammation, and by
limiting further injury to tissue.
Some common home care techniques for knee pain
that control inflammation and help to break the
inflammatory cycle are protection, rest, ice,
compression, and elevation. This regimen is
summarized by the memory device PRICE.
8. PROTECT the knee from further trauma.
This can be done with knee padding or
splinting.
A pad over the kneecap, for example, helps to
control the symptoms of some knee injuries
(an example is a form of bursitis sometimes
called housemaid's knee) by preventing
further repetitive injury to the prepatellar
bursae.
REST the knee.
Rest reduces the repetitive strain placed on the
knee by activity.
Rest both gives the knee time to heal and helps
to prevent further injury.
9. ICE the knee.
Icing the knee reduces swelling and can be
used for both acute and chronic knee injuries.
Most authorities recommend icing the knee 2
to 3 times a day for 20-30 minutes each
time.
Use an ice bag or a bag of frozen vegetables
placed on the knee.
COMPRESS the knee with a knee brace or
wrap.
Compression helps accomplish two goals:
First, compression is another way to reduce
swelling.
Second, in some knee injuries, compression
can be used to keep the patella aligned and
to keep joint mechanics intact.
10. ELEVATE the knee.
Elevation also helps reduce swelling.
Elevation works with gravity to help fluid
that would otherwise accumulate in the
knee flow back to the central circulation.
Prop your leg up when you are sitting, or
use a recliner, which naturally elevates the
legs. Elevation works best when the knee
-- or any other injured body part -- is
higher than the level of the heart.
11. When to Go to the Hospital for Knee Pain
If you cannot put weight on your knee, you should
consider going to the ER to be evaluated by a doctor
because of the possibility of a fracture.
Many fractures may require immobilization in a specific
position or surgery.
Putting off seeing a doctor may hinder healing.
Other signs and symptoms that demand emergency
evaluation:
Fever (which may indicate infection)
Unbearable pain
Drainage
Large wounds
Puncture wounds
Swelling, if you are on a blood thinner
(warfarin or Coumadin) or have a bleeding disorder
(such as hemophilia)
12. The doctor will also want to know a bit
about you.
Do you have any major medical problems?
How active is your lifestyle?
What are the names of the medications you are
taking?
The doctor will want to know about any
related symptoms.
Do you still have normal sensation in
your foot and lower leg?
Have you been having fevers?
13. Physical exam
The doctor will likely have you disrobe to completely expose
the knee. If possible, wear shorts to your appointment.
The doctor will then inspect the knee and press around the
knee to see exactly where it is tender.
In addition, the doctor may perform a number of maneuvers
to stress the ligaments, tendons, and menisci of the knee
and evaluate the integrity of each of these.
X-rays, CT scans, and other tests
Depending on your particular history and exam, the doctor
may suggest X-rays of the knee. X-rays show fractures
(broken bones) and dislocations of bones in the knee as
well as arthritis and abnormally large or small joint spaces.
Rarely, the doctor may order a CT scan (a 3-dimensional X-
ray) of the knee to precisely define a fracture or deformity.
Both X-rays and CT scans are excellent for diagnosing
fractures. They both are also poor, however, at evaluating
soft tissue structures of the knee such as ligaments,
tendons, and the menisci.
14. MRI
Magnetic resonance imaging (MRI) uses large magnets to
create a 3-dimensional image of the knee.
In contrast to CT scans, MRIs do not image bones and
fractures as well.
Also in contrast to CT scans, MRIs are excellent for evaluating
ligaments and tendons for injuries.
Fluid removal
The knee and all bursae of the knee are filled with fluid.
If your symptoms suggest infection or crystalline
arthritis, such as gout, your physician may remove
fluid, with a needle, from the knee.
This fluid will then be analyzed to better clarify the diagnosis.
Crystals, which suggest crystalline arthritis, often can be seen
under the microscope. Infection may also be detected
under a microscope by finding bacteria and pus in the fluid.
Blood tests: The doctor may also elect to perform certain
blood tests to evaluate for signs of infection or diseases
such as rheumatoid arthritis, lupus, and diabetes
15. Arthroscopy
The orthopedic surgeon may elect to perform
arthroscopy if you have chronic knee pain.
This is a surgical procedure where the doctor
will place a fiber optic telescope within the
knee joint. The arthroscope is attached to a
camera that relays real-time images to a
video monitor.
By doing so, the surgeon may be able to see
small particles in the knee or to look more
closely at damaged menisci or cartilage.
The doctor may also be able to repair damage
by shaving down torn cartilage or removing
particles from the knee while looking at the
inside of your knee on a video monitor.
16. Types of Knee Pain
The nerves that provide sensation to the knee
come from the lower back and also provide
hip, leg, and ankle sensation. Pain from a
deeper injury (called referred pain) can be
passed along the nerve to be felt on the
surface. Knee pain, therefore, can arise from
the knee itself or be referred from conditions
of the hip, ankle, or lower back. All of the
following sources of knee pain arise from the
knee joint itself.
In general, knee pain is either immediate
(acute) or long-term (chronic). Acute knee
pains can be caused by an acute injury or
infection. Chronic knee pain is often from
injuries or inflammation (such as arthritis)
but can also be caused by infection.
17. Acute Knee Pain
Sprained and Torn Cruciate Ligaments
Description: An anterior cruciate ligament (ACL) injury is a
common sports injury generally caused by a hard stop or a
violent twisting of the knee. The posterior cruciate ligament
(PCL) is stronger than the ACL and much less commonly
torn. The PCL requires strong forces, such as those
produced when the dashboard strikes the knee in a car
accident, to tear. Due to these severe forces, PCL injury is
often associated with other ligamentand bone injuries.
Symptoms: If you tear your ACL, you may hear a pop. You
will also notice your knee give way or become unstable and
feel pain that is bad enough that you might feel
like vomiting. This will, almost always, be followed by
marked knee swelling over the next couple of hours
because the ACL bleeds briskly when torn.
Treatment: Surgical repair is recommended for high-level
athletes who demand optimal outcomes. Conservative
treatment and knee braces may prove sufficient for those
who do not demand quite so much from their knees.
18. Tendon Ruptures
Description: Both the quadriceps and patellar tendons
may rupture partially or completely. A quadriceps
tendon rupture typically occurs in recreational
athletes older than 40 years (this is the injury former
President Clinton suffered while jogging), and a
patellar tendon rupture typically occurs in younger
people who have had previous tendonitis or steroid
injections to the knee.
Symptoms: Rupture of either the quadriceps or
patellar tendon causes pain (especially when trying to
kick or extend the knee). Those people with complete
ruptures are unable to extend the knee. The patella is
also often out of place either upward (with patellar
tendon rupture) or downward (with quadriceps tendon
rupture).
Treatment: Tendon ruptures should be evaluated
urgently. Tendon ruptures generally require surgical
repair. A partial rupture may be treated with splinting
alone.
19. Meniscal Injuries
Description: Injuries to the meniscus are
typically traumatic injuries but can also be
due to overuse. Often, a piece of the
meniscus will tear off and float in the knee
joint.
Symptoms: Meniscal injuries may cause the
knee to lock in a particular position, or either
click or grind through its range of motion.
Meniscal injuries may also cause the knee to
give way. Swelling typically accompanies
these symptoms although the swelling is
much less severe than with an ACL injury.
Treatment: Meniscal injuries often require
arthroscopic surgical repair. A locking knee or
a knee that "gives" should be evaluated for
arthroscopic repair.
20. Meniscal Injuries
Description: Injuries to the meniscus are
typically traumatic injuries but can also be
due to overuse. Often, a piece of the
meniscus will tear off and float in the knee
joint.
Symptoms: Meniscal injuries may cause the
knee to lock in a particular position, or either
click or grind through its range of motion.
Meniscal injuries may also cause the knee to
give way. Swelling typically accompanies
these symptoms although the swelling is
much less severe than with an ACL injury.
Treatment: Meniscal injuries often require
arthroscopic surgical repair. A locking knee or
a knee that "gives" should be evaluated for
arthroscopic repair.
21. Knee Dislocation
Description: Knee dislocation is a true limb-
threatening emergency. This is also a rare injury.
Dislocation of the knee is caused by a particularly
powerful blow to the knee. The lower leg
becomes completely displaced with relation to
the upper leg. This displacement stretches and
frequently tears not only the ligaments of the
knee but also arteries and nerves. Untreated
arterial injuries leave the lower leg without a
blood supply. If circulation is not
restored, amputation may be required. Nerve
injuries, on the other hand, may leave the lower
leg viable but without strength or sensation.
Symptoms: Knee dislocations are severely painful
and produce an obvious deformity of the knee.
Many dislocations are reduced -- or put back into
alignment -- on their own. As this occurs, many
will report feeling a dull clunk.
22. Treatment: If the knee dislocation has not been put back into place on its
own, the doctor will immediately reduce the dislocation. Medical
treatment, however, does not stop here. Whether a dislocation reduces by
itself or is put back into place in the hospital, it requires further evaluation
and care. After reduction, people with these injuries are observed in the
hospital where they usually do a number of tests to ensure that no arterial
or nerve injury has occurred. If such an injury is found, it must be
repaired immediately in the operating room.
Dislocated Kneecap (patella)
Description: A common injury caused by direct trauma or forceful
straightening of the leg, such as an injury that happens when serving in
volleyball or tennis. Kneecap dislocation is more common in
women, theobese, knock-kneed people, and in those with high-riding
kneecaps.
Symptoms: If you have this injury, you will notice the patella being out of
place and may have difficulty flexing or extending your knee.
Treatment: The doctor will move the patella back into place (reduce the
dislocation). Even if the patella goes back into place by itself, however, it
needs to be X-rayed for a fracture. After reducing the patella and ensuring
the absence of a fracture, the doctors will treat these injuries by splinting
the knee for 3 weeks to allow the soft tissues around the patella to heal
followed by strengthening exercises to keep the patella in line. This injury
often causes damage to the cartilage on the back of the patella.
23. Knee Pain Prevention
Knee pain has a host of causes. Many types
of pain are difficult to prevent, but you
can do some general things to reduce the
likelihood of sustaining a knee injury.
Stay Slim
Staying slim reduces the forces placed on
the knee during both athletics and
everyday walking and may, according to
some medical research, reduce
osteoarthritis.
Keeping your weight down may also reduce
the number of ligament and tendon
injuries for similar reasons.
24. Keep Limber, Keep Fit
Many knee problems are caused by tight or
imbalanced musculature. Stretching and
strengthening, therefore, also help to prevent
knee pain.
Stretching keeps your knee from being too
tight and aids in preventing both
patellofemoral syndrome and iliotibial band
syndrome.
Strengthening exercises particularly of the
quadriceps (straight leg raises and leg
extensions are two excellent exercises, but
please see a book on exercise and training for
more) can help prevent knee injury.
25. Exercise Wisely
If you have chronic knee
pain, consider swimming or water exercises.
In water, the force of buoyancy supports some of
our weight so our knees do not have to.
If you don't have access to a pool or do not enjoy
water activities, at least try to limit hard
pounding and twisting activities such as
basketball, tennis, or jogging.
You may find that your aching knees will act up if
you play basketball or tennis every day but will
not if you limit your pounding sports to twice a
week.
Whatever you do, respect and listen to your body.
If it hurts, change what you are doing.
If you are fatigued, consider stopping -- many
injuries occur when people are tired.
26. Protect the Knee
Wearing proper protection for the activity at
hand can help avoid knee injuries.
When playing volleyball or when laying
carpet, protecting your knees may include
kneepads.
When driving, knee protection may include
wearing a seatbelt to avoid the knee-
versus-dashboard injuries as well as
injuries to other parts of your body.