Term
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Definition
"bow legged"- lateral angulation of the femur and tibia at the knee
occurs from:structual abnormalies at hip,excessive supination of feet,and degeneration of med. meniscus
can lead to: foot supination,external tibial roation,lateral patella pos., external femoral roation |
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Term
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Definition
"knock knees"-medial angulation of the femur and tibia at knee. Knees closer together than ankles at stance
can occur from or lead to: muscular weakness at hip,hyperpronation of feet,internal tibial roation,med. patella pos., internal femoral rotation,degernation of lat meniscus |
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Term
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Definition
when person has greater than 5 degrees of knee hyperextension. Often stands with knees locked in extreme extension
occurs from: hypermobility of joints, PCL and ACL laxity, poor posture
can lead to:increased stress on ACL and tension on post. lat. capsule |
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Term
| Patella Alignment: Patella Alta |
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Definition
high riding patella
camel sign
commonly due to patella tendon ruptures |
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Term
| Patella Alignment: Patella Baja |
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Definition
| low riding patella within trochlear groove |
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Term
| Patella Alignment: Frog Eyed Patella |
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Definition
| patella high riding and lateral |
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Term
| Patella Alignment: Squinting Patella |
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Definition
| patella positioned medially |
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Term
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Definition
used to determine approx tracking of patella and helps quantify the line of pull of quads and resultant forces on patella
measurement from ASIS to patella to tibial tuberosity when knee extended
Q angle for men is 13degrees and women is 18 degrees |
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Term
| Patella Orientation: Medial/Lateral Patella Glide |
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Definition
| position of patella in frontal plane. should be centered between condyles. Can be shifted medially or laterally |
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Term
| Patella Orientation: Patellar Rotation |
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Definition
(spin) longitudinal orientation in frontal plane. long axis of patella should be directed towards ASIS.
If long axis is directly lateral to ASIS then patella is laterally rotated |
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Term
| Patella Orientation: Anterior/Posterior Patella Tilt |
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Definition
rotation in sagittal plane. Inferior patella pole should be palpable when knee is extended and quads are relaxed.
if the patella is anteriorly rotated the superior pole of patella will be depressed |
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Term
| Patella Orientation: Medial/Lateral Patella Tilt |
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Definition
| rotation of patella in transverse plane |
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Term
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Definition
aka sports hernia.
MOI- increased muscular loads placed on the pubic bone and/or pubic symphisis due to high-speed/velocity, twisting, turning. Muscle imbalaces between abdominal, pelvic, and hip predispose.
symptoms: pain with resisted leg adduction or resisted sit ups
management: Conservative:restore muscle balance, strength,ROM Aggressive: herniorrphaphy (replace muscle wall) |
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Term
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Definition
aka Juvenile Kyphosis. When thoracic vertebral bodies wedge anteriorly creating an abnormal rounded spine. Highly genetic, affecting boys more than girls 13-16yoa. often found with scoliosis
symptoms: increased thoracic or lumbar kyphosis that is more apparent with forward flexion, pain/discomfort with activity
management: based on extent/progressive nature of curve (exervise, monitoring, bracing, surgery) |
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Term
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Definition
swelling/inflammation of a vein caused by a blood clot after hospitalization for surgery or major illness
TWO TYPES:deep venous thrombosis-affects deeper/larger veins, Superficial thrombophlebitis-affects veins near skin surface
symptoms:inflammation/swelling in affected body part,pain,redness,warmth,tenderness
management:analgesics,antibiotics,anticoagulants,NSAIDs,thrombolytics |
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Term
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Definition
formation of blood clot in wein that is not inflamed due to prolonged immobilization and causes blood to thicken or slow blood flow
symptoms:hardness of vein, redness,tenderness,pain, poss. fever
management: medications (blood thinners), keep pressure off |
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Term
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Definition
aka groin strain
MOI-tensile,overstretching the muscles,dynamic overload, eccentric contraction,isometric contraction, occurs with "cutting" motion
symptoms:pain over muscle,weakness,swelling,lack of motion,tenderness,ecchymosis
treatment:RICE,NSAIDs,ultrasound,rehab to strengthen muscles and restore ROM,hip spica |
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Term
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Definition
MOI-secondary to an overstretching of fibers or dynamic overload during eccentric contraction
symptoms:pain over muscle,weakness,swelling,lack of motion,tenderness,ecchymosis
treatment:RICE,NSAIDs,ultrasound,rehab to strengthen muscles and restore ROM,hip spica |
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Term
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Definition
MOI-secondary to an overstretching of fibers or dynamic overload during eccentric contraction
symptoms:pain over muscle,weakness,swelling,lack of motion,tenderness,ecchymosis
treatment:RICE,NSAIDs,ultrasound,rehab to strengthen muscles and restore ROM,hip spica |
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Term
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Definition
MOI-hyperextension of the hip, resisted hip flexion, dynamic overload. usually from sprinting or kicking
symptoms:pain over muscle,weakness,swelling,lack of motion,tenderness,ecchymosis
treatment:RICE,NSAIDs,ultrasound,rehab to strengthen muscles and restore ROM,hip spica |
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Term
| Legg-calve Perthes Disease |
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Definition
aka coxa plana. Avascular necrosis of the femoral head in children 4-10yoa (most common in boys). Disruption of circulation at the head of the femur causing articular cartilage to become necrotic and flatten
symptoms:groin pain w/ poss reffered pain to abdomen or knee, poss rapid or chronic onset, poss limited hip motion, pain during examination
management: poss complete bed rest, bracing to avoid weight bearing, if treated in time: bone will reossify, if not: head of femur will become ill shaped causing osteoarthritis |
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Term
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Definition
temporary inflammation of hip lasting a short period of time caused by a viral infection that can settle in hip joint causing swelling and joint pain. pain can pass from one hip to other
symptoms: pain,antalgic gait,hip discomfort,fever,knee/thigh pain,walking on tip toe
management:refer out, ultrasound,poss removal of fluid from joint,NSAIDS,rest, avoid weight bearing |
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Term
| Greater trochanteric bursitis |
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Definition
MOI-friction of IT band as it crosses the bursa or a single blow (women are predisposed due to Q angle)
CAN MIMIC FEMORAL NECK FRACTURE
symptoms:pain over greater trochanter radiating to buttock,reduced hip ROM,difficulty sleeping
management: NSAIDS,cortizone shots,rehab,poss surgery
*can lead to snapping hip syndrome |
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Term
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Definition
associated with rheumatoid arthritis or osteoarthritis
symptoms: pain in anterior hip,poss. palpable mass in the groin or around inguinal ligament
management:RICE,NSAIDs, rehab to include ROM and massage
*can lead to snapping hip syndrome |
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Term
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Definition
the gradual ossification and widening of the pubic symphisis caused by rotational, tension, or shearing forces place on symphysis. can be acute or chronic activities like running,soccer,iceskating
symptoms:pain centered over pubic symphysis and lower abdominal and adductor muscles, spasming, walking or rising from seated position will apply shear force=painful.
CAN MIMIC GROIN STRAIN,DISTINGUISH WITH PAIN FROM SEATED TO STANDING POSITION
management:rest/immobilization,crutches,orthosis, stretching exercises to lengthen muscles aroudn hip and groin |
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Term
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Definition
caused by a tremendous torsional or shearing force to shaft of femur
symptoms:deformity,immediate loss of function,extreme pain
management:control bleeding/treat for shock if compound,splint in pos found,activate EMS if femoral artery is compromised,surgery,NSAIDS |
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Term
| Femoral neck stress fracture |
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Definition
MOI-weight bearing loads and muscular tension placing forces on femoral neck. seen most in endurance athletes and female runners
symptoms:deep,aching pain from hip or groin that increases with activity and relieved by rest,ROM limited and painful near end ranges,decreased strength,parasthesia
management: PRICEM, refer out of PRICEM doesnt work, bone scan, surgery |
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Term
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Definition
most serious ligament injury of knee usually caused by direct blow to the knee or deceleration w valgus stress and rotation. Most vulnerable when tibia is ER and knee is in a valgus pos.
symptoms:pop followed by disability,c/o "shifting",swelling at joint line,pos. lachman and ant draw
management:PRICEM,refer to orthopedist,MRI,poss. surgery |
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Term
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Definition
MOI-fall on a bent knee with speed or significant force (ie falling while skiing)
symptoms:feel pop in back of knee,tenderness,swelling in pop fossa,laxity in post sag, pos post draw and adduction stress test at 30 degrees in full ext.
management:PRICEM, if grade 1or2-quad strengthening exercises, poss surgery,immobilization in ext |
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Term
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Definition
MOI- direct blow from lateral side causing a valgus force or ER
symptoms: pain,tenderness,swelling,joint tightness,positive valgus stress test
management: PRICEM,hinged rehab brace and exercises |
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Term
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Definition
MOI- result of varus force usually with tibia IR. may result in damage to IT band and biceps femoris as well
symptoms: pain,tenderness,swelling,laxity w/ varus stress test
management: PRICEM,hinged rehab brace and exercises |
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Term
| Posteriolateral corner injuries |
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Definition
injury of the structures on the lateral and posteriolateral aspect of the knee involving ant displacement of lat condyle on tibia and tibia externally rotates while femur internally rotates
MOI-due to blows to the anteromedial aspect of knee,contact and noncantact hyperextension, and varus contact injuries to a flexed knee that results in tissue damage that allows the lat tibial plateau to externally rotate around medially shifted axis and causes a post subluxation relative to the femur |
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Term
| Symptoms/management for posteriolateral corner injuries |
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Definition
localized pain to poterolateral aspect of knee but tension on the medial structures and change in rotational axis may produce pain in medial knee, "giving away" sensation during activity or static stance, swelling, nonweight bearing ROM not affected
management: heel-lifts to prevent full extension, surgical procedures
*SPECIAL TESTS:dial test, ER recurvatum test, posterolateral drawer test, reverse pivot shift |
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Term
| Anteriomedial rotary instabilities |
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Definition
aka AMRI. Anterior subluxation and ER of the medial tibial plateau with respect to the femur. Triad injury involving the ACL,MCL,and medial meniscus
symptoms:pop/snap at time of injury,swelling,knee feels unstable,often associated with unhappy triad
management:radiograph, possible surgery
*SPECIAL TESTS: slocum drawer test,crossover test, isolated tests for ACL and MCL |
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Term
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Definition
MOI: seen commonly in elderly. occurs from falling from a standing position OR high forces like car accidents or falling from sig. height STABLE: closed simple fracture UNSTABLE: occurs from sig forces causing multple fractures
symptoms:pain in groin/hip.low back/abdomen and worsens with movement, dif walking or standing
management: activate EMS, may cause damage to surrounding structures which can cause lifethreatening conditions, poss surgery |
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Term
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Definition
due to repetitive cyclical forces created by ground reaction forces (ie, distance running). seen most commonly in females due to Qangle
symptoms:groin pain,aching sensation increased with activity,may not be possible to stand on one leg,point tenderness
management: if stress frac is on pubis or ischium, use crutches, rest 2-5 months, swim for aerobic exercise |
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Term
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Definition
inflammation of the synovial membrane of the hip. usually an acute injury that occurs on just one hip not both. common in children(boys) between 3-10yoa
symptoms:pain at hip,trouble walking,poss pain around inner thigh or knee, pain may subside w/in 4-5 days
management: rest,poss synovectomy,NSAIDs,xrays |
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Term
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Definition
MOI-strong contraction of muscle/tendon that pulls off a piece of bone.
symptoms: pain will fall at origin of contracted muscles
management: PRICEM, refer to orthopedist |
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Term
| Slipped capital femoral epiphysis |
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Definition
separation of the ball of the hip joint from the femur at the growth plate of the bone caused by displacement in the upper epiphysis while the bone is still growing
symptoms: outward turning of the leg,difficulty walking,gait,knee/hip pain and stiffness,restricted hip movements
management: PRICEM,refer to orthopedist,surgery to stabilize the bone with pins/screws to prevent further displacement |
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Term
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Definition
| stretching of ant/post horns of the meniscus that produce a vertical-longitudinal tear due to forcefully extending knee from a flexed position while the femur is internally rotated |
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Term
| Parrot beak meniscal tear |
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Definition
| tear on the edge of the cartilage inwards that forms when the meniscus splits in two directions due to repetitive stress |
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Term
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Definition
| tear that divides meniscus in top and bottom portions. usually seen in older population |
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Term
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Definition
| outcome of a strong sudden strong internal rotation of the femur with a partially flexed knee with a fixed foot; meniscus becomes pinched between condyles |
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Term
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Definition
| an oblique tear due to forceful knee extension with femur externally rotated |
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Term
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Definition
direct force to the front of leg near knee that causes forcible hyperextension (ie car accidents)
symptoms: extreme pain, loss of function,tenderness,deformity,swelling,discoloration
management: activate EMS,splint in pos found,monitor dorsal pedal pulse,cap refill, skin tmp |
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Term
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Definition
laterally structures torque patella laterally with planting, deceleration and simultaneous cutting that creates a valgus force. PREDISPOSERS: genu valum,shallow femoral grooves,foot pronation,patella malalignment
symptoms: pain,swelling,restricted flx/ext, POP over adductor tubercle where patella femoral lig attaches
management:crutches, tap patella back in place, relax VMO or else it will continue to torque, strengthen muscles |
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Term
| Patellofemoral stress syndrome |
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Definition
anterior knee pain due to abnormal motion or pressure between patella and femur thats seen w/ in the trochlear groove due to overuse, weak VMO,bony alignment
symptoms: dull/achy pain in front/sides knee,increased pain w activity, weakness/instability
management: limit stressful ADLs, rest, strengthen, PRICEM |
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Term
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Definition
softening and degeneration of the cartilage under kneecap due to overuse
symptoms: POP above knee, grinding sensation when knee is extended, pain worsens after sitting for long time, climbing stairs, out of chair. (+) patella grind. can lead to necrosis.
management: PRICEM, PT, limit stressful activities
will mimic meniscal injury but will not be able to produce catching/grinding with meniscal special tests |
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Term
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Definition
aka jumpers knee. overuse injury when excessive stress is put on patella tendon
symptoms: pain w activity, inflammation, POP, poss creptius
management: rest, ice, massage, stretch, strengthen, cho-pad |
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Term
| Osgood Schlatters disease |
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Definition
constant pull of quads tendon on tibial tuberosity that can cause a gap; body tries to fill gap with new bone growth leading to bony lump over tubercle. seen in adolescents
symptoms: POP over prominence, swelling, pain w activity, tight quads
treatment: symptoms usually disappear after bone finishes growing, NSAIDS, strengthening exercises |
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Term
| Singing Larsen Johansson disease |
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Definition
growth forms at inferior pole of patella that causes tendon to become more stiff, less pliable, and changes function of patella due to repetitive stress. usually seen in children 11-14
symptoms: pain/swelling at inf pole of patella, POP, pain w quad stretching/function, poss visible deformity
treatment: rest, ice, stretching and strengthening of quads, PT |
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Term
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Definition
direct blow to the knee. can usually affect VMO. patella lacks protective muscular strutures so it is prone to bruising
symptoms: pain, loss of movement, swelling, discoloration, poss effusion, capsular brusising effected with deep bone brusies or muscle contus.
management: depends on severity/location, compression wraps, RICE, protective padding |
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Term
| Osteochondritis dissecans |
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Definition
partial or complete separation of piece of articular cartilage or subchondral bone becomes necrotic and a fragment breaks off and usually gets caught near med. femoral condyle in joint line
symptoms: achy knee, recurrent swelling, occasional lock or catch, point tender
management: children=conservative methods, teens=surgery for bones are harder and will effect structure
will mimic meniscal, but special tests for meniscal tear will be (-). only occasional locking |
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Term
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Definition
general term for all MOI that cause condylar damage.
symptoms: often masked by concurrent injury, "locking" sensation,knee giving away, "clunking", pain increased w weight bearing
management: depends on location of defect w respect to weigh bearing surface, modified activity,surgery |
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Term
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Definition
synovial folds that did not fully absorb are irritated due to blunt force trauma. most common is medipetallar plica what covers infrapatellar fat pad
symptoms: pseudolocking, snapping heard when knee passes 15-20 deg flx, locking, pain w stairs, no lig laxity, no swelling, (-) meniscal special tests
management: rest, NSAIDs, local heat, surgery if leads to other conditions |
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Term
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Definition
tendonitis of sartorius, gracilis and semitendinosus due to excessive genu valgum, weak VMO, execessive hull running w one leg higher than other
symptoms: pain and tenderness in med pop fossa, esp w stairs, inflammaton
management: correct foot/leg alignment, ice, proper stretching, NSAIDS, avoid stressful activitie |
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Term
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Definition
overuse injury caused by poor biomechanics, poor training, tight popliteal muscle or tear
symptoms:pain in post knee and w resisted knee flx when tib ext rotated, POP, tight hamstrings, full knee ext uncomfortable
management: rest, NSAIDs, ultrasound, strengthen muscles
could mimic post lat capsule instabilities |
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Term
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Definition
inflammation of the infrapatellar bursa. SUPERFICIAL-lies infront of tendon DEEP- lies between patella ligament and proximal anterior tib
MOI- kneeling in upright pos, direct trauma, repetitive overuse
symptoms: swelling, POP, tenderness, pain w flx/ext
management:RICE, NSAIDs, refer if pain doesnt go away |
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Term
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Definition
inflammation of pes anserine bursa which separates the insertions of the sartorius, gracilis, and semitendinosus from the tibial plateau from direct blow, repetitive friction
symptoms: ant knee pain, tenderness, POP
management: stretching of hamstrings/quads, PRICEM, refer if pain doesnt go away |
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Term
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Definition
inflammation of synovium secondary to the presence of existing inflammation
symptoms: boggy, wrmth, pain throughout joint, pain w activity and aching at rest, swollen
management: PRICEM, cortisone injections, surgery |
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Term
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Definition
inflammation of suprapatellar bursa thats between the lower part of the thigh and the tendon of the quads muscle due to overuse, direct trauma, rep microtrauma, or bacterial infection
symptoms: swelling, POP, tenderness
management: NSAIDs, refer to orthopedist if pain doesnt stop |
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Term
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Definition
posterior displacement of femoral head usually when hip is flexed and adducted w an axial force delivered to femur that causes the head to be driven through post capsule
symptoms: immediate intense pain w/in joint and buttock, "going out" feeling, usually shown with hip adducted, flexed and internal rotation, AROM impossible
management: activate EMS, asses cap refill, skin temp, circulation, treat for shock |
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Term
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Definition
result of a fall onto flexed knee w hip adducted that caused femoral head to force into post acetabulum that allows joint to spontaneously reduce
symptoms: immediate intense pain, "going out" feeling, can lead to fractures/contusions, stresses ligaments |
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Term
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Definition
result of repeated subluxations, slipped capital epiphysis, acetabular dysplasia, repeated impingment ant femoral head/acetabulum
symptoms: "catching", pain in ant hip/groin or lat hip, pain increases with activity
management: conservative treatment, arthroscopy
SPECIAL TESTS: hip scouring and trendenelburg |
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Term
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Definition
iliac crest contusion from direct blow. worst injury to hip besides fracture. seen mostly in football/volleyball
symptoms: POP, tenderness, loss of function, any movement causes pain, paresthesia over lat thigh, muscle spasms
management: PRICEM, crutches, xrays, donut pad |
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Term
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Definition
aka coxa saltans. palpable audible snapping within hip as joint flexes and extends. IT band slides over greater trochanter and during hip flx band snaps over trochanter
symptoms: pain usually over greater trochanter, snapping felt/seen w hip flx/ext
management: conservative, RICE, NSAIDs, avoid stressful activities |
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Term
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Definition
direct blow to quads
symptoms: decreased strength w knee ext, pain, spasms, POP, discoloration
management: non-weight bearing, PRICEM, compression, maintain ROM |
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Term
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Definition
secondary to severe muscle strain or contusion which the impact causes damage to the periostium and bone grows within the muscle
symptoms: restricted ROM, pain, hard lump in muscle
management: care for contusion, rest, NSAIDs, surgery |
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Term
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Definition
due to twisting upper body with both feet planted on the ground that produces irritation and stretching of sacrospinous ligaments
symptoms: POP, tenderness/muscle guarding, radiating pain,sitting to standing=pain, ASIS/PSIS assymmetric, side bending=pain
management: modalities, bracing, improve stability in joint |
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Term
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Definition
spasm or hypertrophy of the piriformis muscle that places pressure on the sciatic nerve as it passes through the muscle
symptoms: symp increased w contraction of muscle or prolonged sitting, buring, pain, paresthesia, heightened during straight leg raising test, passive hip IF and resisteed ER w seated patient
management: stretching, strengthening, surgical release
CAN LOOK LIKE SCIATICA BUT SPECIAL TESTS WILL DIFFERENTIATE |
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Term
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Definition
"lowback pain". lumbrosacral lig short thick triangular tissue that connects the ant-inf L5 to lat surface of base of sacrum. sprain caused by sudden force/movement extended on lig (twist, turn, bend)
symptoms: localized low back pain, dull ache/sharp with certain movements, limited ROM, sitting to standing=pain
management: PRICEM, backbrace, strengething exercises for abs/back extensors |
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Term
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Definition
sprain to ligs between vertebrae due to a sudden force or movement that extends the ligs (twist, turn, bend)
symptoms:localized back pain thats constant dull/sharp w certain movements, limited ROM
management: PRICEM, back braces, strengtening |
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Term
| Erector spinae muscle strain |
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Definition
ilicostalis, longissimus, and spinalis are primary movers for back movement. MOI- sudden force/movement/load twisting, turning, bending, picking up heavy object. flatback/scoliosis predispose
symptoms:localized or diffused pain during active ext and passive flx
management: PRICEM, ice massage, brace, strengthening exercises |
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Term
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Definition
defect in pars interarticularis that is usually brought on by rep stress. can occur bilaterally or unilaterally. "scotty dog" deformity.
symptoms: localized back pain that increases during/after activity, ext is aggrivating and symp are alleviated w flx, pain restricts ext
management: based on symp, exercises to strengthen deficit, avoid ext exercises |
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Term
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Definition
worsening of spndylosis. complete separation of ant portion due to complete deficit of pars articularis that causes spinal instability an for ant movment of superior vertebra
symptoms: pain increased with ext, AROM will feel "catch" when returning upright, pain more intense/constant in lumbar region, poss flattening of buttocks when viewed laterally
special test= single leg stance test
management: based on symp, rehab excersies avoiding ext, lumbar brace |
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Term
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Definition
cervical instability as a result of acute trauma including whiplash mechanisms or rep motion. facet capsule impinged between 2 facet surfaces that results in loss of normal function
symptoms: post neck pain during ext and rotation of cervical spine, clicking or catching, localized pain just lat to spinous processes
management: heat/ice to alleviate pain, NSAIDs, chiropractor, restraint collar=cervical region, good posture, low back support |
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Term
| Intervertebral disc lesion |
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Definition
protrusion of nucleus pulpsus of an intervertebral disc through a weakened area in annulus fibrosis. the prolapsed tissue from the nucleus pulposus presses on nerve root just below it and causes pain down leg
symptoms: sudden/severe pain in thigh/calf/foot, sciatic pain may be present, weak dorsi flexors, forward flexion restricted and causes spasms, flattened lumbar spine
management: rest in comfortable pos., analgesics, avoid movement, AROM/PROM of legs |
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Term
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Definition
associated with peripheral nerve root compression caused by intervertebral disc protrusion, structural abnormalities, or tight piriformis muscle. sciatic nerve is vulnerable to torsion and direct blows
symptoms: acute or gradual, sharp shooting pain down post med thigh, paresthesia, nerve sensitive to palpate, straight leg raising intensifies pain
management: rest, find cause of inflammation, lumbar traction if due to disc protrusion, stretch for tight piriformis, NSAIDs, pos surgery |
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