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, Move” Throughout the physical examination compare the asymptomatic to the symptomatic knee. The kneeexam 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
Knee pain - assessment: How should I examine a person with knee pain? Examination | Diagnosis | Knee pain - assessment | CKS | NICE Search CKS… Menu ExaminationKnee 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
Costs and effectiveness of a brief MRI examination of patients with acute knee injury Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Role of sonographic examination in traumatic knee internal derangement. OBJECTIVES: To define the accuracy (compared with magnetic resonance imaging [MRI]) of sonographic examination in detecting knee effusion and to determine whether the presence of knee effusions in patients with traumatic knee injury can predict knee internal derangement as assessed by MRI. DESIGN: Prospective study. SETTING: Hospital rehabilitation department. PARTICIPANTS: Thirty patients (19 men, 11 women) with traumatic (...) knee injury were recruited. Subjects received sonographic examination and MRI on the same day. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The presence or absence of knee effusion was assessed by sonographic examination. MRI was used as criterion standard to evaluate whether the presence of knee effusion and internal derangement, which included tear of anterior and posterior cruciate ligaments, as well as meniscus tear. RESULTS: The sensitivity of sonographic examination for detecting
Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination. While most meniscal or ligamentous knee injuries heal with nonoperative treatments, a subset should be treated with arthroscopic or open surgery.To analyze the accuracy of the clinical examination for meniscal or ligamentous knee injuries.MEDLINE (1966-December 31, 2000) and HealthSTAR (1975-December 31, 2000) databases were searched for English-language articles (...) describing the diagnostic accuracy of individual examination items for the knee and a combination of physical examination items (composite examination). Other data sources included reference lists from relevant articles.Studies selected for data extraction were those that compared the performance of the physical examination of the knee with a reference standard, such as arthroscopy, arthrotomy, or magnetic resonance imaging. Eighty-eight articles were identified, of which 23 (26%) met inclusion
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