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Knee Exam

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13501. Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. (Abstract)

Risk factors for clinically relevant pulmonary embolism and deep venous thrombosis in patients undergoing primary hip or knee arthroplasty. Prevention of thromboembolic complications after elective lower extremity arthroplasty has increasingly relied on routine thromboprophylaxis in all patients. Not all patients are at equal risk, however, and prophylaxis is not devoid of complications. The aim of this study was to examine the risk factors for clinically relevant pulmonary embolism and deep (...) venous thrombosis after elective primary hip or knee arthroplasty in a large patient population.During the 10-yr study period, 116 of 9,791 patients undergoing primary hip or knee arthroplasty at the authors' institution who experienced pulmonary embolism or deep venous thrombosis within 30 days of surgery were matched at a 1:1 ratio with patients undergoing the same surgery with the same surgeon who did not experience an adverse event. Medical records were reviewed, with data abstracted using

2003 Anesthesiology

13502. Comparison of A Mobile-Bearing Total Knee System With A Fixed-Bearing Total Knee System In Cemented Total Knee Arthroplasty

degrees. Patients were asked to return for examination and radiographs at 3 months, 1 year, 2 years, and 5 years after surgery. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 240 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Participant) Primary Purpose: Treatment Official Title: A Prospective, Randomized, Controlled Study Comparing A Mobile-Bearing Total Knee System With A Fixed (...) -surgery, 5 years post-surgery ] The range of knee motion was measured clinically with use of a goniometer. Measurements were performed by physician assistants in the Department of Orthopedic Surgery who were blinded to the type of implant used. The subject was positioned supine on the examination table, and maximum active flexion was measured. Secondary Outcome Measures : Knee Society Function Score [ Time Frame: 5 years post surgery ] The Knee Society Function Score considers only walking distance

2007 Clinical Trials

13503. Computer-Assisted Total Knee Replacement Kinematics: DePuy Sigma Posterior Cruciate Substituting Knee and the DePuy Sigma RP Rotating Platform Knee

: Randomized Intervention Model: Factorial Assignment Masking: Single (Participant) Primary Purpose: Treatment Official Title: An Investigation of Computer-Assisted Total Knee Replacement Kinematics on Patient Performance: An Examination of the DePuy P.F.C.® SigmaTM Posterior Cruciate Substituting Knee and the DePuy P.F.C.® Sigma RP Rotating Platform Knee Systems Study Start Date : October 2006 Actual Primary Completion Date : December 2012 Actual Study Completion Date : December 2012 Resource links (...) Computer-Assisted Total Knee Replacement Kinematics: DePuy Sigma Posterior Cruciate Substituting Knee and the DePuy Sigma RP Rotating Platform Knee Computer-Assisted Total Knee Replacement Kinematics: DePuy Sigma Posterior Cruciate Substituting Knee and the DePuy Sigma RP Rotating Platform Knee - 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

2006 Clinical Trials

13504. Rheumatological History, Examination and Investigations

the patient walking, turning, and walking back. Look for smoothness and symmetry of the arm, leg, and pelvic movements, ability to turn quickly, and length of stride. Knee assessment and hip examination: with the patient on on the couch, flex each hip and knee while holding the knee to check movement and for knee crepitus. Check for internal and external rotation of the hip. Examine each knee for joint effusion: Stroke upwards over the medial side of the knee and downwards over the lateral side. Patellar (...) tap sign: Spread the thumb and index finger and place web space about six inches above knee joint. Press down and distally (pushing fluid from the suprapatellar pouch into the knee joint). Then press down on the patella, noting any lag before the patella hits the femur and bulging to the side as fluid is displaced, indicating an effusion is present. Check the feet for synovitis by squeezing across the metatarsals. Examine for callosities, deformities and high or low arch. Spine Neck and back

2008 Mentor

13505. Neurological Examination of the Upper Limbs

their knees together while you try to elicit the reflexes again. Interpretation Upper motor neurone lesions usually produce hyperreflexia. Lower motor neurone lesions usually produce a diminished or absent response. Isolated loss of a reflex can point to a radiculopathy affecting that segment - eg, loss of biceps jerk if there is a C5-C6 disc prolapse. Examination of co-ordination The cerebellum helps in the co-ordination of voluntary, automatic and reflex movement. Tests of cerebellar function, however (...) Neurological Examination of the Upper Limbs Neurological Examination of the Upper Limbs. Information | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Neurological Examination of the Upper Limbs Authored by , Reviewed by | Last edited 12 Oct 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors

2008 Mentor

13506. Neurological Examination of the Lower Limbs

the ankle raises off the bed as well, signifying increased tone. Test for ankle clonus: Flex the patient's knee, resting the ankle on the bed. Dorsiflex the foot quickly and keep the pressure applied. You will be able to see the foot moving up and down if clonus is present. Power A robust assessment of power is required. The Medical Research Council (MRC) has a recommended grading system for power (see table). Get the patient to contract the muscle group being tested and then you as the examiner try (...) to overpower that group. Test the following: [ ] Hip flexion, extension, adduction and abduction. Knee flexion and extension. Foot dorsiflexion, plantar flexion, eversion and inversion. Toe plantar flexion and dorsiflexion. MRC scale for muscle power 0 No muscle contraction is visible. 1 Muscle contraction is visible but there is no movement of the joint. 2 Active joint movement is possible with gravity eliminated. 3 Movement can overcome gravity but not resistance from the examiner. 4 The muscle group can

2008 Mentor

13507. Examination of the Spine

Examination of the Spine Examination of the Spine. Information about spine exams. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Examination of the Spine Authored by , Reviewed by | Last edited 21 Aug 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) and European Guidelines. You may find one of our more useful. In this article In This Article Examination of the Spine In this article Neck and back pain are common presentations in primary care. Many cases of neck and back pain are due to benign functional or postural causes but a thorough history and examination are essential to assess the cause (see separate articles , and ), any associated psychological difficulties (eg, depression, anxiety or somatisation disorder) and any functional impairment

2008 Mentor

13508. Paediatric Examination

, the child lies very still with flexed knees and shallow breaths. Inspect the anogenital area if appropriate. This is an increasingly difficult examination as children get older and requires sensitive handling. Warm hands and reassurance are needed to palpate the abdomen of an ill child. Neurological and developmental examination: Formal examination is very difficult. Improvisation is often required. Cranial nerves are examined by observation - for example, of behavioural and facial movements. Cranial (...) : Observation is again most important. Peak flow measurement is not reliable until about age 5 years (see separate article ). Gastrointestinal examination: It is often best to examine kneeling down alongside the patient. Children may prefer palpation to be done with their hand underneath the examiner's. Hip and knee examination: Irritable hip and other hip conditions can occur at this age and require assessment. Normal genu varus (physiological in the toddler) and valgus (physiological in the pre-school

2008 Mentor

13509. Abdominal Examination

. It can also be seen in the tongue, foot or any skeletal muscle. Take the fingers in your palm and hyperextend them. A positive flap is a flexion-extension movement at a slow rate. Alternatively, with the patient relaxed, supine and knees bent, feet flat on couch, the knees may flap as the legs fall to the side. It is not specific for hepatic encephalopathy but occurs also in, for example, chronic kidney disease, respiratory failure, electrolyte disturbance and drug intoxication. Examination (...) or reversed if you are left-handed and examine from the patient's left side. A pillow under the patient's knees may sometimes aid relaxation of abdominal musculature. Ask the patient to point to the site of any pain. During palpation, be aware of the response of the patient's abdominal muscles and watch their face for signs of discomfort. Start with light palpation to gain the patient's confidence and relax them and then perform deeper palpation. Use the flat of the hand with the flexor surfaces

2008 Mentor

13510. Rectal Examination

: Suitable gloves Lubricant Lighting Suitable soft tissues Position the patient comfortably, as below. Details of the procedure Position the patient comfortably in the left lateral position. Flex hips and knees and position the buttocks at the edge of the couch. Gently part the buttocks to expose the anal verge and natal cleft. Inspection of the skin and anal margin with good light is important. Lubricate the examining index finger with suitable water-soluble gel and press the finger against (...) the posterior anal margin (6 o'clock according to convention). The finger should slip easily into the anal canal, and the finger tip is directed posteriorly following the sacral curve. At this point, if appropriate, the anal tone can be checked by asking patients to squeeze the finger with their anal muscles. The finger is then moved through 180°, feeling the walls of the rectum. With the finger then rotated in the 12 o'clock position, helped usually by the examiner bending knees in a half crouched position

2008 Mentor

13511. Genitourinary History and Examination (Female)

suggesting irritable bowel disease or other gut pathology. This is an important cause of dyspareunia. Renal angle tenderness suggesting a renal cause for pain. Ascites: percussion reveals lateral dullness and a tympanic central abdomen. Examining external genitalia Prepare for examination: Position the patient with help of a chaperone on to the couch (supine, flexed hips and knees with heels together, thighs abducted). Cover the patient's abdomen with a sheet. Position lighting to give a clear view (...) Genitourinary History and Examination (Female) Genitourinary History and Examination (Female) | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Genitourinary History and Examination Female Authored by , Reviewed by | Last edited 20 Jun 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based

2008 Mentor

13512. Gynaecology History and Examination

that the handle is not impinging on the clitoris. Look at the vaginal mucosa and locate the cervix. Note any discharge. Take a vaginal swab if there is discharge present. Consider a cervical swab for chlamydia. Check for any retained tampon. If no cervix visualised : Try partially withdrawing and try again. Perform a bimanual examination to establish the position of the cervix. Ask the patient to hold on to her knees or put hands under the sacrum to tilt the pelvis. A pillow could also be used. The left (...) Gynaecology History and Examination Gynaecological History and Examination. Advice and Info | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Gynaecological History and Examination Authored by , Reviewed by | Last edited 23 Jun 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based

2008 Mentor

13513. Examining the Pulse (Different Types)

Examining the Pulse (Different Types) Pulse Examination. Cardiovascular (CVS) examination. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Pulse Examination Authored by , Reviewed by | Last edited 8 May 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence (...) , UK and European Guidelines. You may find one of our more useful. In this article In This Article Pulse Examination In this article It is very easy to overlook the art of clinical examination when new technology can so easily be employed to make diagnoses. Systematic cardiovascular examination can provide a diagnosis quickly without need for invasive or expensive tests. Such routine examination can reveal an unexpected and timely diagnosis. Historically, in the Middle or Far East, doctors were

2008 Mentor

13514. Does this patient have a torn meniscus or ligament of the knee: value of the physical examination

Does this patient have a torn meniscus or ligament of the knee: value of the physical examination Does this patient have a torn meniscus or ligament of the knee: value of the physical examination Does this patient have a torn meniscus or ligament of the knee: value of the physical examination Solomon D H, Simel D L, Bates D W, Katz J N, Schaffer J L Authors' objectives To analyse the accuracy of the clinical examination for meniscal or ligamentous knee injury. Searching MEDLINE and HealthSTAR (...) were searched from inception to 2000. The keywords included: 'knee', 'physical examination', 'internal derangement', 'anterior cruciate ligament', 'posterior cruciate ligament', 'medial collateral ligament', 'lateral collateral ligament' and 'meniscus'. The references lists from relevant articles were handsearched. The searches were limited to studies reported in the English language. Study selection Study designs of evaluations included in the review Diagnostic accuracy studies were included

2001 DARE.

13515. Can the presence of equinus contracture be established by physical exam alone? (Abstract)

Can the presence of equinus contracture be established by physical exam alone? The condition in which ankle dorsiflexion is restricted is known as equinus contracture (EC). Equinus contracture is purported to be associated with a number of clinical conditions. However, there are no data to support or refute a clinician's ability to diagnose EC by clinical exam. We prospectively evaluated the maximum ankle dorsiflexion with the knee fully extended in 68 people (34 patients with isolated fore (...) - or midfoot pain and 34 asymptomatic subjects) both by clinical exam and by a custom-designed ankle goniometer. We compared the likelihood of agreement of the clinical impression (equinus, no equinus) to the maximum ankle dorsiflexion measured with the instrument at two different numerical definitions of EC (< or =5 degrees and < or =10 degrees of maximum dorsiflexion). When all subjects were included and equinus defined as < or =5 degrees of ankle dorsiflexion, a clinician's ability to detect the equinus

2001 Journal of rehabilitation research and development Controlled trial quality: uncertain

13516. Exploring the use of videotaped objective structured clinical examination in the assessment of joint examination skills of medical students. Full Text available with Trip Pro

at Freeman Hospital, Newcastle (UK). Student performance on OSCE stations for shoulder or knee examinations was assessed by experienced rheumatologists. The stations were also videotaped and scored by a rheumatologist independently. The examinations consisted of a 14-item checklist and a global rating scale (GRS).Mean values for the shoulder OSCE checklist were 17.9 by live assessment and 17.4 by video (n = 50), and 20.9 and 20.0 for live and video knee assessment, respectively (n = 45). Intraclass (...) correlation coefficients for shoulder and knee checklists were 0.55 and 0.58, respectively, indicating moderate reliability between live and video scores for the OSCE checklists. GRS scores were less reliable than checklist scores. There was 84% agreement in the classification of examination grades between live and video checklist scores for the shoulder and 87% agreement for the knee (kappa = 0.43 and 0.51, respectively; P < 0.001).Video OSCE has the potential to be reliable and offers some advantages

2007 Arthritis and rheumatism Controlled trial quality: uncertain

13517. A cross sectional study of 100 athletes with jumper's knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Full Text available with Trip Pro

for more than 12 months. Forty nine of the subjects had two or more separate episodes of symptoms. Ultrasonography showed a characteristics hypoechoic region at the junction of the inferior pole of the patella and the deep surface of the patellar tendon. Histopathological examination showed separation and disruption of collagen fibres on polarisation light microscopy and an increase in mucoid ground substance consistent with damage of tendon collagen without inflammation.Jumper's knee has the potential (...) A cross sectional study of 100 athletes with jumper's knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Jumper's knee causes significant morbidity in athletes of all standards. However, there are few reference data on the clinical course of this condition in a large number of patients, and the aim of this study was to rectify this.A retrospective study of the course of jumper's knee in 100 athletes who presented to a sports medicine clinic over

1997 British Journal of Sports Medicine

13518. Arthroscopy of the knee. Ten-day pain profiles and corticosteroids. (Abstract)

Arthroscopy of the knee. Ten-day pain profiles and corticosteroids. A prospective study was conducted to determine 10-day pain and analgesic use profiles of outpatients after arthroscopic surgery of the knee and to examine the effects of oral corticosteroid use on analgesic intake, perceived pain, and functional outcomes. Sixty-two patients who underwent a variety of arthroscopic procedures of the knee were matched on level of injury and surgical repair, and were assigned to two groups (...) patients who have undergone arthroscopic surgery of the knee perceive pain at low levels, use limited amounts of analgesics, and return to work within a week. The addition of oral corticosteroids does not influence this profile.

1993 American Journal of Sports Medicine

13519. Instrumented evaluation of knee laxity: a comparison of five arthrometers. (Abstract)

Instrumented evaluation of knee laxity: a comparison of five arthrometers. We performed a prospective study on 50 subjects with normal knees and 50 patients with chronic unilateral disruption of the anterior cruciate ligament. In a randomized testing sequence, both groups were examined with five arthrometers: the MEDmetric KT-1000, the Stryker Knee Laxity Tester, the Acufex Knee Signature System, the Dyonics Dynamic Cruciate Tester, and the Genucom Knee Analysis System. Each examination (...) was performed according to protocol with the knee at 30 degrees of flexion. The total anterior laxity measurements of the normal subjects using the Dyonics Dynamic Cruciate Tester and Acufex Knee Signature System were approximately half of the KT-1000, Stryker, and Genucom values. A comparison of the side-to-side measurements revealed no statistically significant difference in the values of the five arthrometers. However, the Genucom showed an unacceptably high number of normal subjects with laxity values

1992 American Journal of Sports Medicine Controlled trial quality: uncertain

13520. An evaluation of pre- and postoperative nonsteroidal antiinflammatory drugs in patients undergoing knee arthroscopy. A prospective, randomized, double-blinded study. (Abstract)

An evaluation of pre- and postoperative nonsteroidal antiinflammatory drugs in patients undergoing knee arthroscopy. A prospective, randomized, double-blinded study. The potential benefits of a nonsteroidal antiinflammatory drug to 67 patients undergoing knee arthroscopy were evaluated in a prospective, randomized, placebo-controlled, double-blinded study. Group A received the drug (diclofenac, 75 mg twice daily) for 3 to 5 days before and for 7 days after surgery. Group B received a placebo (...) preoperatively and the drug postoperatively. Group C received a placebo at both times. Codeine was available postoperatively for all patients if needed. Outcomes reported by the subjects included pain, crutch use, and return to activities. Outcomes assessed by physicians included knee effusion, range of motion, and gait. Knee flexion and extension strengths were measured isokinetically pre- and postoperatively. Pain scores on the 1st postoperative day were higher in Group C than in Group A. Pain scores

1993 American Journal of Sports Medicine Controlled trial quality: uncertain

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