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Knee Exam

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1. Exam Series: Guide to the Knee Exam

Exam Series: Guide to the Knee Exam Exam Series: Guide to the Knee Exam - CanadiEM Exam Series: Guide to the Knee Exam In by Kathryn Chan June 5, 2018 A 22 year old female comes to emergency department unable to walk. She was in the middle of a rugby game when she caught the ball while pivoting quickly, and was tackled shortly thereafter. She immediately heard a “pop” and says that the swelling in her right leg has increased substantially over the last hour. Background: The knee is a complex (...) hinge joint and one of the most common sites of MSK injuries. Fortunately a diagnosis is usually possible with a good history and physical exam! Four ligaments – the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) connect the femur to the tibial plateau, ensuring proper alignment and providing stability. Two menisci cushion the articulating surfaces while several bursa further reduce friction around the knee

2018 CandiEM

2. Exam Series: Guide to the Back Exam

the asymptomatic leg is raised. This test has higher specificity but lower sensitivity compared to the straight leg raise. Test Sensitivity Specificity Likelihood Ratio (LR) Straight Leg Raise 91% 26% 3.74 Cross Straight Leg Raise 29% 88% 4.39 Clinical Utility of Special Tests in the Lumbar Spine Exam 3 Femoral Nerve Root Irritation: Femoral stretch test: Position the patient prone and have them flex one knee to 90°. Grasp the patient’s ankle and extend the hip; radicular pain in the thigh suggests femoral (...) Exam Series: Guide to the Back Exam Exam Series: Guide to the Back Exam - CanadiEM Exam Series: Guide to the Back Exam In , by Kathryn Chan July 23, 2018 A 67-year-old male presents to your emergency room with back pain. He has a history of intermittent back pain that typically responds to NSAIDs, however this particular episode has been much more severe. He now feels sharp pain that radiates into this left foot with certain movements, which causes weakness when walking. His past medical

2018 CandiEM

3. Diagnostic Performance of Knee Physical Exam and Participant-Reported Symptoms for MRI-Detected Effusion-Synovitis among Participants With Early or Late Stage Knee Osteoarthritis: Data from the Osteoarthritis Initiative. (PubMed)

Diagnostic Performance of Knee Physical Exam and Participant-Reported Symptoms for MRI-Detected Effusion-Synovitis among Participants With Early or Late Stage Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Evaluate the diagnostic performance of knee physical exam findings and participant-reported symptoms for MRI-detected effusion-synovitis (ES) among knees with early and late-stage osteoarthritis (OA).The Osteoarthritis Initiative (OAI) is a longitudinal study of participants (...) with or at risk for knee OA. Two samples with MRI readings were available: 344 knees with early OA (312 participants) and 216 with late-stage OA (186 participants). Trained examiners performed bulge sign (BS) and patellar tap (PT) exams, and participants reported on knee swelling and pain with leg straightening. Effusion-synovitis on 3T non-contrast MRI was scored using the MRI Osteoarthritis Knee Score (MOAKS). Diagnostic performance of physical exam findings and symptoms was estimated with bootstrapped

2018 Osteoarthritis and Cartilage

4. A Case of Fatal Colonic Perforation without Abdominal Exam Findings

examination revealed crepitus extending from the left groin to below the left knee despite an abdominal exam which continued to lack rigidity, tenderness, or guarding. Repeat CT imaging revealed subcutaneous and deep thigh soft tissue emphysema extending from the retroperitoneum likely originating from a colonic perforation. An emergent surgery consultation was made; however, the patient and family elected not to pursue surgical intervention, opting instead for comfort measures. The patient expired early (...) A Case of Fatal Colonic Perforation without Abdominal Exam Findings Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings – Clinical Correlations Search Spotlight: A Case of Fatal Colonic Perforation without Abdominal Exam Findings June 14, 2018 6 min read By Christopher Sonne, MD Peer reviewed Learning Objectives: 1. Understand the pathophysiology of peritonitis secondary to bowel perforation. 2. Understand how classic findings of peritonitis can be absent in some

2018 Clinical Correlations

5. Knee Exam

Knee Exam Knee Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Knee Exam Knee Exam Aka: Knee Exam , Knee Examination , Knee Joint (...) Finding , Knee Maneuver II. Exam: General (compare with less affected knee) Observation with obscured landmarks See See See Previous surgical scars resting position Quadriceps muscle atrophy Evaluate Vastus Medialis Obliquus specifically Atrophy often on side of Tenderness to Palpation Tibial tubercle r tendon Quadriceps tendon Joint line Pes Anserine Bursa Iliotibial Band Normal Range of Motion Flexion: 135 degrees Extension: 0 to -10 degrees (above horizontal plane) III. Exam: Patellofemoral (Q

2018 FP Notebook

6. Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis ? A Randomized Clinical Trial

was the injection of 1 mL of triamcinolone 40 mg/mL; the control group received 1 mL of 0.9% normal saline. In both arms, synovial fluid (≤10 mL) was aspirated prior to the injection. Participants attended 9 visits over a 24-month period, which were scheduled at 3-month intervals. Each visit included a knee exam and assessments of pain and stiffness. Participants were also subject to radiographs, ultrasound, and magnetic resonance imaging (MRI) at standardized intervals. From the MRI, mean cartilage thickness (...) Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis ? A Randomized Clinical Trial Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis – A Randomized Clinical Trial – Clinical Correlations Search Gamechanger? The Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee

2018 Clinical Correlations

7. I guess that’s positive: soft-embalmed cadavers and a medical student’s journey towards physical exam competency

out a variety of medical conditions. They play an important role in medical education. But, what SPs cannot do is accurately reproduce physical exam findings. For instance, it would be impossible for even the Denzel Washington of SPs to accurately produce the laxity of a knee with an ACL tear. As third- and fourth-year medical students, we are expected to use the physical exam skills learned during the first two years to accurately diagnose patients in the clinical setting. The question (...) I guess that’s positive: soft-embalmed cadavers and a medical student’s journey towards physical exam competency I guess that’s positive: soft-embalmed cadavers and a medical student’s journey towards physical exam competency | BJSM blog - social media's leading SEM voice by By James Ross Bailey During the first two years of medical school, students are taught physical exam maneuvers by either practicing on each other or by using Standardized Patients (SPs). These SPs are paid actors that act

2019 British Journal of Sports Medicine Blog

8. Knee stability and movement coordination impairments: knee ligament sprain revision 2017.

Knee stability and movement coordination impairments: knee ligament sprain revision 2017. Knee stability and movement coordination impairments: knee ligament sprain revision 2017. | National Guideline Clearinghouse success fail May JUN Jul 09 2017 2018 2019 18 May 2018 - 09 Jun 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites (...) at . ArchiveBot's source code can be found at . TIMESTAMPS Search Sign In Username or Email * Password * Remember Me Don't have an account? The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. For additional information, read our . Guideline Summary NGC:011308 2017 Nov NEATS Assessment Knee stability and movement coordination impairments: knee ligament

2017 National Guideline Clearinghouse (partial archive)

9. Robotically Simulated Pivot Shift That Represents the Clinical Exam. (PubMed)

Robotically Simulated Pivot Shift That Represents the Clinical Exam. A thorough understanding of anterior cruciate ligament (ACL) function and the effects of surgical interventions on knee biomechanics requires robust technologies and simulation paradigms that align with clinical insight. In vitro orthopedic biomechanical testing for the elucidation of ACL integrity doesn't have an established testing paradigm to simulate the clinical pivot shift exam on cadaveric specimens. The study aim (...) was to develop a robotically simulated pivot shift that represents the clinical exam. An orthopedic surgeon performed a pivot shift on an instrumented ACL-deficient cadaver leg to capture 6 degree-of-freedom motion/loads. The same knee was mounted to the robot and the sensitivity of the motion/loading profiles quantified. Three loading profile candidates that generated positive pivot shifts on the instrumented knee were selected and applied to 7 ACL-intact/deficient specimens and resulted

2019 Journal of Orthopaedic Research

10. Examiner effect on the objective structured clinical exam – a study at five medical schools (PubMed)

Examiner effect on the objective structured clinical exam – a study at five medical schools The Objective Structured Clinical Examination (OSCE) is increasingly used at medical schools to assess practical competencies. To compare the outcomes of students at different medical schools, we introduced standardized OSCE stations with identical checklists.We investigated examiner bias at standardized OSCE stations for knee- and shoulder-joint examinations, which were implemented into the surgical

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2017 BMC medical education

11. Walking cane: knee osteoarthritis

Walking cane: knee osteoarthritis RACGP - Walking cane for knee osteoarthritis Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship Fellowship International (...) graduates FRACGP exams RACGP offer courses and events to further develop the knowledge you need to develop your GP career Re-entry to general practice Supervisors and examiners Mental Health (GPMHSC) Research Discover a world of educational opportunities to support your lifelong learning Courses and events QI&CPD Online learning Conferences Become a provider with the QI&CPD Program and be recognised for the quality education and training you offer GPs Curriculum for Australian General Practice Programs

2016 Handbook of Non-Drug interventions (HANDI)

12. Exercise for knee osteoarthritis

Exercise for knee osteoarthritis RACGP - Handbook of Non-Drug Interventions (HANDI) Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship Fellowship International (...) graduates FRACGP exams RACGP offer courses and events to further develop the knowledge you need to develop your GP career Re-entry to general practice Supervisors and examiners Mental Health (GPMHSC) Research Discover a world of educational opportunities to support your lifelong learning Courses and events QI&CPD Online learning Conferences Become a provider with the QI&CPD Program and be recognised for the quality education and training you offer GPs Curriculum for Australian General Practice Programs

2016 Handbook of Non-Drug interventions (HANDI)

13. Taping: knee osteoarthritis

Taping: knee osteoarthritis RACGP - Knee taping for osteoarthritis Search Become a student member today for free and be part of the RACGP community A career in general practice Starting the GP journey Enrolments for the 2019.1 OSCE FRACGP exams closing 29 March 2019 Fellowship FRACGP exams Research Practice Experience Program is a self-directed education program designed to support non vocationally registered doctors on their pathway to RACGP Fellowship Fellowship International graduates FRACGP (...) exams RACGP offer courses and events to further develop the knowledge you need to develop your GP career Re-entry to general practice Supervisors and examiners Mental Health (GPMHSC) Research Discover a world of educational opportunities to support your lifelong learning Courses and events QI&CPD Online learning Conferences Become a provider with the QI&CPD Program and be recognised for the quality education and training you offer GPs Curriculum for Australian General Practice Programs for educators

2016 Handbook of Non-Drug interventions (HANDI)

14. CRACKCast E057 – Knee and Lower Leg

brachial BP / systolic ankle BP If > 0.9 = negative predictive value of 100% in knee dislocation Serial physical exams – 7% miss rate Pedal pulses serially Sens = 79%, spec = 91%, NPV = 93% Treatment : Reduction! Traction, counter-traction Splint in a long leg splint HARD signs: A disrupted artery needs to be repaired ASAP in the OR 90% amputation after 8 hrs of injury Isolated intimal tears identified on CT imaging are treated with observation vs. Anticoagulation ABI and or serial exams IF normal (...) CRACKCast E057 – Knee and Lower Leg CRACKCast E057 – Knee and Lower Leg - CanadiEM CRACKCast E057 – Knee and Lower Leg In , by Adam Thomas January 9, 2017 This episode of CRACKCast covers Chapter 57 of Rosen’s Emergency Medicine, Knee and Lower Leg. Continuing on with the orthopaedic chapters and objectives, this episode reviews the relevant approaches to knee and lower leg injuries that are actionable in the emergency department setting. Shownotes – Also check out the EM Cases Rapid Review

2017 CandiEM

15. Tales of Survival: Physical Exam

Tales of Survival: Physical Exam Tales of Survival: Physical Exam – Clinical Correlations Search Tales of Survival: Physical Exam July 15, 2011 6 min read By John Hwang General Patient is a demented, chronically ill elderly male lying in bed attached to a ventilator, appearing anything but his stated age. Contracted in a fetal position, huddled under the bed sheet with only his bald head and wrinkled skin showing, he alternately resembles a centenarian or a newborn child—someone very much (...) at the brink of life. Mental Status Exam Patient awake and alert, but severely cognitively impaired. Completely nonverbal and does not repeat or respond to commands. He looks observers in the eye, but he does not recognize faces and generally remains expressionless. On occasion, though, he spontaneously breaks into a beaming, ear-to-ear toothless smile that always surprises me, and at which I cannot help but sheepishly smile back. The entire room seems to light up, if only briefly, and even the doctors

2011 Clinical Correlations

16. Assessing musculoskeletal examination skills and diagnostic reasoning of 4th year medical students using a novel objective structured clinical exam (PubMed)

Structured Clinical Exam (OSCE) focusing on HDPE skills for disorders of the shoulder, back and knee, and used it to explore medical student diagnostic reasoning.A multidisciplinary group of musculoskeletal specialists developed and gathered validity evidence for a three station OSCE focusing on the HDPE of the shoulder, back and knee, emphasizing the ability to anticipate (identify pre-encounter) expected physical exam findings, and subsequently perform discriminatory physical examination maneuvers (...) between anticipation and performance scores was computed for each maneuver and their relationship to diagnostic accuracy was tested with logistic regression.Inter-rater reliability was good (ICC between .69 and .87) for six exam maneuvers. Maneuver performance was overall poor, with no discriminatory maneuver performed correctly by more than two thirds of students, and one maneuver only performed correctly by 4 % of students. For the shoulder and knee stations, students were able to anticipate

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2016 BMC medical education

17. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review. (PubMed)

Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review. A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk (...) physiotherapy evidence database (PEDro) scale.Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5-6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2-18.4; P < 0.05), hip external:internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle

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2016 Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

18. Neurologic Exam

Reflexes Babinski Reflex Grasp Reflex Suck Reflex Glabellar Reflex Hoffman Reflex XI. Exam: Cerebellar Dysmetria Overshooting target Alternating hand movements Heel-knee-shin Romberg Test Walking on base of foot Tandem walking Overall coordination Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Neurologic Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip (...) Neurologic Exam Neurologic Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Neurologic Exam Neurologic Exam Aka: Neurologic Exam

2018 FP Notebook

19. Newborn Abdominal Exam

Exam Aka: Newborn Abdominal Exam II. Technique: Abdominal exam Perform abdominal exam with infants hips and knees flexed Hold knees up with non-dominant hand while palpating with the opposite hand Relaxes the newborn's Palpate for masses Use flats of fingers (instead of finger tips) Infant liver is typically palpable just below the costal margin III. Exam: Abdominal findings Hyperpigmented vertical line from the to the pubic symphysis and resolves with time from maternal hormone exposure Suggests (...) Newborn Abdominal Exam Newborn Abdominal Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Newborn Abdominal Exam Newborn Abdominal

2018 FP Notebook

20. Newborn Exam

. ) or (e.g. ) Gray ation due to (occult spinal cord lesion) s ( versus ) or e (e.g. ) Abnormal lesions associated with or syndromes (in some cases) (skull deformities) or port wine stain ( , Klippel-Trenaunay-Weber Sydrome) (epidermal nevus syndrome, malignant potential) (malignant potential) ( , Tuberous Sclerosis, Albright Syndrome) IX. Exam: Abdomen and Rectum See Perform abdominal exam while supporting infants hips and knees in flexed position Observe abdominal contour for (congenital ) or distention (...) Newborn Exam Newborn Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Newborn Exam Newborn Exam Aka: Newborn Exam , Neonatal Exam

2018 FP Notebook

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