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The Ottawa knee rules are a set of rules used to help physicians determine whether an x-ray of the knee is needed. [1] They state that an X-ray is required only in patients who have an acute knee injury with one or more of the following: Age 55 years or older; Tenderness at head of fibula; Isolated tenderness of patella
This complex is the major stabilizer of the medial knee. Injuries to the medial side of the knee are most commonly isolated to these ligaments. [1] [3] A thorough understanding of the anatomy and function of the medial knee structures, along with a detailed history and physical exam, are imperative to diagnosing and treating these injuries.
A knee dislocation is an injury in which there is disruption of the knee joint between the tibia and the femur. [3] [4] Symptoms include pain and instability of the knee. [2] Complications may include injury to an artery, most commonly the popliteal artery behind the knee, or compartment syndrome. [3] [4] [7]
Iliotibial band syndrome (ITBS) is the second most common knee injury, and is caused by inflammation located on the lateral aspect of the knee due to friction between the iliotibial band and the lateral epicondyle of the femur. [2] Pain is felt most commonly on the lateral aspect of the knee and is most intensive at 30 degrees of knee flexion. [2]
Pain is generally just below the kneecap. [2] Symptoms may worsen if the knee is overly straightened or bent for too long a period. [2] Complications may include an inability to fully straighten the knee. [2] The underlying mechanism may involve bleeding, inflammation, or insufficient space for the fat pad. [2]
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner positions himself by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee.
High quality MRI images (1.5 T magnet or higher [22]) of the knee can be extremely useful to diagnose injuries to the posterolateral corner and other major structures of the knee. [23] While the standard coronal , sagittal and axial films are useful, thin slice (2 mm ) coronal oblique images should also be obtained when looking for PLC injuries.
There are several types of inflammation that can cause knee pain, including sprains, bursitis, and injuries to the meniscus. [9] A diagnosis of prepatellar bursitis can be made based on a physical examination and the presence of risk factors in the person's medical history ; swelling and tenderness at the front of the knee, combined with a ...