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Knee Exam

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1. Knee pain - assessment: How should I examine a person with knee pain?

Knee pain - assessment: How should I examine a person with knee pain? Examination | Diagnosis | Knee pain - assessment | CKS | NICE Search CKS… Menu Examination Knee pain - assessment: How should I examine a person with knee pain? Last revised in July 2017 How should I examine a person with knee pain? Examine and compare both knees and surrounding structures. Inspect for wounds, erythema, deformity, muscle atrophy and swelling. Palpate for warmth, swelling (including bony swelling, effusion (...) and bursal or other soft tissue swelling) and tenderness. Move the knee s by extending and flexing as far as possible. The normal range is zero degrees of extension to 135 degrees of flexion. Examine the hips, ankles and spine for other joint pathology causing referred pain to the knee, particularly in children. Assess gait and ability to weight bear. Assess for signs of septic arthritis, particularly if the person has any risk factors - see . If there is a history of trauma, as well as the above: Use

2018 NICE Clinical Knowledge Summaries

2. Exam Series: Guide to the Knee Exam

, Move” Throughout the physical examination compare the asymptomatic to the symptomatic knee. The knee exam should be conducted with the patient supine, examining a knee in a chair or wheelchair can significantly compromise your exam! Every patient will have a different laxity to their joints at baseline, use the asymptomatic knee to get a sense of the patients baseline laxity. Pain with provocative movements without associated laxity suggests a ligament strain rather than a tear. Remember to assess (...) pulses (posterior tibial and dorsalis pedis) using palpation, Doppler, or bedside ultrasound. Serial physical examinations are necessary, with the addition of an Ankle-Brachial Index (ABI <0.9 is abnormal) as popliteal injury still occurs in up to 15% of patients with palpable peripheral pulses 1 . CT angiography should be considered in all knee dislocations. Neurovascular exam should be documented before and after reduction of dislocations. Nerve Origin Motor function Sensory function Reflexes Deep

2018 CandiEM

3. Cigarette smoking and knee osteoarthritis in the elderly: Data from the Korean National Health and Nutritional Examination Survey. (Abstract)

Cigarette smoking and knee osteoarthritis in the elderly: Data from the Korean National Health and Nutritional Examination Survey. The relationship between smoking and osteoarthritis (OA) has not been investigated in a large-scale study. The aim of this study was to examine the relationship between smoking and knee OA in the elderly.This study included 5117 subjects aged >60 years who responded to questionnaires on their history of smoking and knee OA diagnosed by a physician taken from (...) the Korean National Health and Nutritional Examination Survey (KNHANES-VI) 2013-2015. We classified all 5117 subjects into 2 groups (the OA group and non-OA group) and compared the demographics and characteristics between the 2 groups. A multivariate logistic regression analysis was conducted to investigate the possible association between knee OA and smoking.The prevalence of current smoking in the OA group (5.1%) was significantly lower than in the non-OA group (14.6%; p < 0.001). Furthermore

2020 Experimental Gerontology

4. Relationship of breastfeeding duration with joint pain and knee osteoarthritis in middle-aged Korean women: a cross-sectional study using the Korea National Health and Nutrition Examination Survey. Full Text available with Trip Pro

Relationship of breastfeeding duration with joint pain and knee osteoarthritis in middle-aged Korean women: a cross-sectional study using the Korea National Health and Nutrition Examination Survey. The effect of joint health on the quality of life of middle-aged and older women is becoming more widely recognized with the aging of the world's population. However, the association of long-term breastfeeding with joint pain and knee osteoarthritis has not been fully examined. The aim of this study (...) was to determine the association of prior breastfeeding duration with current joint pain and knee osteoarthritis in middle-aged Korean women.This cross-sectional study was conducted among 3454 women aged ≥50 years who underwent knee radiography and answered a questionnaire on breastfeeding and joint pain for the 5th Korea National Health and Nutrition Examination Survey (2010-2011). After adjusting for confounding sociodemographic, medical history, and obstetric and gynecologic variables, logistic regression

2020 BMC Women's Health

5. Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle. Full Text available with Trip Pro

Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle. Both universal goniometer and electro-goniometer are used for measuring joint range of motion in physiotherapy. Active knee extension test is a way to assess hamstring shortness in patients with chronic low back pain. The aim of this study was to assess universal goniometer and electro (...) -goniometer reliability in measuring knee angle during active knee extension test.This was an intra-examiner reliability study between three measurements of knee extension angle that conducted on 45 patients with chronic low back pain having short hamstring muscle that referring to Kermanshah University of Medical Sciences clinic from 2016 to 2017. Knee extension angle was measured three times during active knee extension test with both universal goniometer and electro-goniometer.The measurement of knee

2019 BMC sports science, medicine and rehabilitation

6. The Use of Teaching Associates for Knee and Shoulder Examination: A Comparative Effectiveness Analysis. (Abstract)

The Use of Teaching Associates for Knee and Shoulder Examination: A Comparative Effectiveness Analysis. Musculoskeletal diseases and injuries are the most common cause of long-term pain and physical disability. Thus, every medical graduate should be able to perform a structured examination of the musculoskeletal system. Besides the see-one-do-one principle, other teaching methods have been proposed to be effective. The use of teaching associates offers an established, proven pathway (...) for teaching examination skills in urology and gynecology. During the patient experience method, students are examined first, thus giving them an opportunity to feel the examination before performing it themselves. The objective of this study was to compare the efficiency of 3 distinct teaching methods for both knee and shoulder examination.The study took place during obligatory knee and shoulder examination training. Participants received basic training, including a demonstration of the structured

2019 Journal of Surgical Education

7. The association between asymptomatic hyperuricemia and knee osteoarthritis: data from the third National Health and Nutrition Examination Survey. (Abstract)

The association between asymptomatic hyperuricemia and knee osteoarthritis: data from the third National Health and Nutrition Examination Survey. In vitro and clinical studies suggest that urate may contribute to osteoarthritis (OA) risk. We tested the associations between hyperuricemia and knee OA, and examined the role of obesity, using a cross-sectional, nationally representative dataset.National Health and Nutrition Examination Survey (NHANES) III used a multistage, stratified probability (...) cluster design to select USA civilians from 1988 to 1994. Using NHANES III we studied adults >60 years, with or without hyperuricemia (serum urate > 6.8 mg/dL), excluding individuals with gout (i.e., limiting to asymptomatic hyperuricemia (AH)). Radiographic knee OA (RKOA) was defined as Kellgren-Lawrence grade ≥ 2 in any knee, and symptomatic radiographic knee osteoarthritis (RKOA) (sRKOA) was defined as RKOA plus knee pain (most days for 6 weeks) in the same knee.AH prevalence was 17.9% (confidence

2019 Osteoarthritis and Cartilage

8. Pilot Study Examining Feasibility and Comparing the Effectiveness of Decision Aids for Hip and Knee Osteoarthritis: A Randomized Trial. Full Text available with Trip Pro

Pilot Study Examining Feasibility and Comparing the Effectiveness of Decision Aids for Hip and Knee Osteoarthritis: A Randomized Trial. Background. There are many patient decision aids (DAs) available, yet there is limited evidence on comparative effectiveness of different tools. Objective. To examine feasibility of a study protocol and gather preliminary data on comparative effectiveness. Methods. Adult patients seeing a surgeon to discuss treatment for hip or knee osteoarthritis were (...) randomized to hip and knee DAs from two vendors. Pre-visit survey included Hip/Knee Decision Quality Instrument, DA usage, health literacy, and quality of life (EQ-5D). Surgical status was ascertained 6 months post-visit. We examined response rates, eligibility, and compared the two DAs on amount of use, knowledge scores, and receipt of preferred treatment. Results. Overall response rate was 58/74 (78%) and did not differ by study arm. More patients in DA-A group reported reviewing all the DAs (64.5% DA

2019 MDM Policy & Practice Controlled trial quality: uncertain

9. A prospective randomized trial examining the use of a closed suction drain shows no influence on strength or function in primary total knee arthroplasty. (Abstract)

A prospective randomized trial examining the use of a closed suction drain shows no influence on strength or function in primary total knee arthroplasty. The aim of this study was to determine whether closed suction drain (CSD) use influences recovery of quadriceps strength and to examine the effects of drain use on secondary outcomes: quadriceps activation, intra-articular effusion, bioelectrical measure of swelling, range of movement (ROM), pain, and wound healing complications.A total of 29 (...) patients undergoing simultaneous bilateral total knee arthroplasty (TKA) were enrolled in a prospective, randomized blinded study. Patients were randomized to receive a CSD in one limb while the contralateral limb had the use of a subcutaneous drain (SCDRN) without the use of suction ('sham drain'). Isometric quadriceps strength was collected as the primary outcome. Secondary outcomes consisted of quadriceps activation, intra-articular effusion measured via ultrasound, lower limb swelling measured

2019 The Bone & Joint Journal Controlled trial quality: uncertain

10. 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. Full Text available with Trip Pro

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 (...) 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

2018 Osteoarthritis and Cartilage

11. A Phase 2 Clinical Trial to Examine the Comparative Effects on Osteoarthritic Knee Pain of CGS-200-1, CGS-200-5, and CGS-200-0

A Phase 2 Clinical Trial to Examine the Comparative Effects on Osteoarthritic Knee Pain of CGS-200-1, CGS-200-5, and CGS-200-0 A Phase 2 Clinical Trial to Examine the Comparative Effects on Osteoarthritic Knee Pain of CGS-200-1, CGS-200-5, and CGS-200-0 - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached (...) the maximum number of saved studies (100). Please remove one or more studies before adding more. A Phase 2 Clinical Trial to Examine the Comparative Effects on Osteoarthritic Knee Pain of CGS-200-1, CGS-200-5, and CGS-200-0 The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03528369 Recruitment Status

2018 Clinical Trials

12. Comorbidities and health-related quality of life in Koreans with knee osteoarthritis: Data from the Korean National Health and Nutrition Examination Survey (KNHANES). Full Text available with Trip Pro

Comorbidities and health-related quality of life in Koreans with knee osteoarthritis: Data from the Korean National Health and Nutrition Examination Survey (KNHANES). This study aimed to evaluate the association of knee osteoarthritis (OA) with comorbidities and health-related quality of life (HRQOL).A total of 8,907 (weighted n = 13,687,058) participants aged ≥50 years who had undergone knee radiography were selected from the 2010-2012 Korea National Health and Nutrition Examination Survey. OA (...) , p < 0.001 and β-coefficient = -0.13, p < 0.001) compared with the non-OA group, whereas ROA only was not associated with limitations in physical activity or lower HRQOL score.Comorbidities were not significantly associated with knee OA after adjustment. Knee OA was associated with physical activity and HRQOL. Painful knee OA, with or without ROA, was more strongly associated with decreased physical activity and lower quality of life than ROA without pain.

2017 PLoS ONE

13. Association between bone mineral density and knee osteoarthritis in Koreans: the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. Full Text available with Trip Pro

Association between bone mineral density and knee osteoarthritis in Koreans: the Fourth and Fifth Korea National Health and Nutrition Examination Surveys. The objective of the study was to investigate the association of hip and lumbar spine (LS) bone mineral density (BMD) with the presence and severity of radiographic knee osteoarthritis (OA), including both men and women over 50 years of age, while adjusting for potential confounders.Cross-sectional data from 5793 community-dwelling subjects (...) (2491 men and 3302 women) aged ≥ 50 years in the Korea National Health and Nutrition Examination Surveys (KNHANES) were analyzed. BMDs for femoral neck (FN), total hip (TH), and LS were measured using dual-energy X-ray absorptiometry. Radiographic changes relating to OA were assessed using the Kellgren-Lawrence (KL) grading scale. The mean BMD, according to the presence of knee OA (KL grade ≥ 2) and the KL grades, were analyzed using the general linear models (GLM) adjusted for anthropometric

2018 Osteoarthritis and Cartilage

14. Association of physical examination knee effusion with bone marrow lesions: cross-sectional and longitudinal analyses of a population-based cohort. Full Text available with Trip Pro

Association of physical examination knee effusion with bone marrow lesions: cross-sectional and longitudinal analyses of a population-based cohort. To determine the association of effusion detected by physical examination with the prevalence of bone marrow lesions (BMLs) on magnetic resonance imaging (MRI), and the incidence/progression of BMLs over 3 years in subjects with knee osteoarthritis.A population-based cohort with knee pain (n = 255) was assessed for effusion on physical examination (...) %, respectively, and 21.2, 85.6, 30.1, and 78.8% respectively.BMLs on MRI can be predicted from physical examination effusion cross-sectionally, with a high PPV of 79.9%. Assessment for knee effusion on physical examination is useful for determining potential candidates with BMLs before costly MRI screening for recruitment into clinical trials.© 2018, American College of Rheumatology.

2018 Arthritis care & research

15. Knee Examination under Anesthesia: Development of a Predictive Score for Partial Anterior Cruciate Ligament Tears Full Text available with Trip Pro

Knee Examination under Anesthesia: Development of a Predictive Score for Partial Anterior Cruciate Ligament Tears To determine the accuracy of knee examination under anesthesia (EUA) and develop a prognostic score for partial anterior cruciate ligament (ACL) tears.A total of 229 patients with an ACL injury were included. Knee EUA was performed using the Lachman test, pivot shift test and arthrometric maximum manual side-to-side difference (AMMD) test. The arthroscopic examination is the gold

2018 Knee surgery & related research

16. Diagnostic utility of ultrasound versus physical examination in assessing knee effusions: a systematic review and meta-analysis

Diagnostic utility of ultrasound versus physical examination in assessing knee effusions: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any (...) and can provide insight into the relationship between study characteristics (e.g. species, sex or drug class or dose) and effect size. They should be considered hypothesis-generating. Ideally, a threshold describing the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species

2020 PROSPERO

17. Diagnostic findings caused by cutting of the iliotibial tract and anterolateral ligament in an ACL intact knee using a standardized and automated clinical knee examination. Full Text available with Trip Pro

Diagnostic findings caused by cutting of the iliotibial tract and anterolateral ligament in an ACL intact knee using a standardized and automated clinical knee examination. The purpose of this study was to evaluate the separate contribution of the two definitions of the anterolateral ligament (ALL), the mid-third lateral capsular ligament (MTLCL) and deep capsule-osseous layer of the iliotibial tract (dcITT) in addition to the superficial iliotibial tract (sITT) to the control of tibial motion (...) with respect to the femur during the application of force/torque seen during the three tests of the standard clinical knee examination (AP Lachman test, tibial axial rotation test and varus-valgus stress test).Six pelvis-to-toe cadaveric specimens were examined using an automated testing device that carried out the three components of the clinical knee examination. Internal/external rotation torque, anteroposterior load and adduction/abduction torque were applied, while torque/force and positional

2017 Knee Surgery, Sports Traumatology, Arthroscopy

18. AIUM Practice Parameter for the Performance of a Peripheral Venous Ultrasound Examination

, and the distal femoral vein is closer to the knee. The longitudinal or long axis is AIUM Practice Parameter for the Performance of a Peripheral Venous Ultrasound Examination 2 J Ultrasound Med 2020; 9999:1–8parallel to or along the length of the vein. Transverse or short axis is perpendicular to the long axis of the vein. Compression can be documented by using cine clips or without and with compression images. “It is the consensus of the ACR’s Economics Committee on Coding and Nomenclature and the ACR’s (...) AIUM Practice Parameter for the Performance of a Peripheral Venous Ultrasound Examination PRACTICEPARAMETERS AIUM Practice Parameter for the Performance of a Peripheral Venous Ultrasound Examination Introduction T heAmericanInstituteofUltrasoundinMedicine(AIUM)isa multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of clinical practice parameters, and accreditation of practices

2020 American Institute of Ultrasound in Medicine

19. Exam Series: Guide to the Back Exam

of the cervical spine. Assess for flexion, extension, and lateral flexion (fingers should touch the fibula) of the back, ensuring that the patient keeps their leg straight and recognizing that tight hamstrings may limit range of motion. Rotation is best assessed with the patient seated in order to isolate movement of the back from the hips. A power examination of the back is not necessary. GI/GU exam : A digital rectal exam is required to assess tone if there are any concerns for cauda equina. A post void (...) 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

2018 CandiEM

20. Appropriateness and Total Knee Arthroplasty: An Examination of the American Academy of Orthopaedic Surgeons Appropriateness Rating System. Full Text available with Trip Pro

Appropriateness and Total Knee Arthroplasty: An Examination of the American Academy of Orthopaedic Surgeons Appropriateness Rating System. The American Academy of Orthopaedic Surgeons (AAOS) recently published appropriateness criteria for patients with knee osteoarthritis (OA) who are being considered for total knee arthroplasty (TKA). We evaluated the extent to which predictor variables used by the AAOS contribute to final classification, rated as "appropriate," "may be appropriate" or "rarely (...) appropriate."The RAND/UCLA Appropriateness method was used by AAOS to develop 864 clinical vignettes, each incorporating eight evidence-based variables associated with TKA outcome or need. Variables included function-limiting pain severity, knee OA severity, knee motion and age among others. The contribution of each variable to the overall classification was determined using multinomial regression. A classification tree method was applied to determine the combinations of variables that contributed

2017 Osteoarthritis and Cartilage

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