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Examination of Knee Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The patellofemoral joint is part of the quadriceps mechanism. The patella lies between the quadriceps muscle superiorly and the patellar tendon distally, which anchors it to the tuberosity of the tibia. The quadriceps angle (Q angle) is formed by the intersecting lines formed by the pull of the quadriceps mechanism and patellar tendon. Clinically, the angle is calculated in an extended knee position (standing patient). A straight line is drawn from the anterior superior iliac spine to the center of the patella and another line from the center of the tibial tuberosity to the patella’s center (Figure 10.3). A significant variation in the Q angle (normal is approximately 6°) indicates altered quadriceps pull. This may predispose to patellar subluxation.
Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Inspection: Knee effusion.Surrounding skin for the signs of direct trauma.Hemarthrosis, hematoma, and ecchymosis.Difficulty standing, there is more pain when weight bearing on the affected leg.The patella easily slips out when flexion.Measure the Quadriceps Angle (Q-angle).
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The major structural abnormalities of the femur are femoral anteversion and large Q angle. The Q angle expresses the geometric relationship between the pelvis, femur, patella, and tibia in the frontal plane. It is measured as the acute angle between a line drawn from the anterior superior iliac spine of the pelvis to the centre of the patella and a line drawn from the centre of the patella to the tibial tuberosity. It provides an indication of the medial angulation of the femur between the hip joint and the knee joint, which accommodates the difference between the width of the pelvis and the base of support at the feet. This angle is typically higher in women as a result of their wider pelvis relative to femur length. The Q angle is one of the structural measures that have been investigated by sports biomechanists in an attempt to determine the cause of lower extremity overuse injuries, such as those that occur during running.
Injury in elite women’s soccer: a systematic review
Published in The Physician and Sportsmedicine, 2020
Tahani A. Alahmad, Philip Kearney, Roisin Cahalan
The reviewed studies provided limited evidence supporting an association between several functional and anatomical risk factors and injury among elite women soccer players. These factors including a better performance in a functional square-hop test [22], excessive lower knee valgus in drop jump landing test [23], and an H/Q ratio less than 55% during concentric contraction of both quadriceps and hamstring tested at 90 degrees of knee flexion [22]. Additionally, an increased incidence of injury was recorded in players with higher BMI [21]. Injury incidence was not found to be affected by individual differences in Q-angle, intercondylar notch width, and pelvic width measurements [21]. Finally, this review showed that women soccer players sustained more injuries in their dominant limb [3].
Reliability of postural measures in elite badminton players using Posture Pro 8
Published in Physiotherapy Theory and Practice, 2018
Kim Hébert-Losier, Fahmi Abd Rahman
The Q-angle (or quadriceps angle) is frequently studied and employed in clinical practice. The Q-angle is said to largely represent alignment of the lower extremity in the frontal plane (Nguyen, Boling, Levine and Shultz, 2009), with abnormal Q-angles associated with injury-prone dynamic movement patterns (Nguyen, Shultz and Schmitz, 2015) and increased risk of injury (Cowan et al., 1996). In a systematic review of the literature; Smith, Hunt and Donell (2008) reported substantial disagreement in the intra- and inter-rater reliability of clinical Q-angle measures (ICC range: 0.20–0.75). The clinical Q-angle is conventionally assessed using a goniometer in a supine position; however, Q-angle measurement in standing has become a position of choice in more recent investigations (Moncrieff and Livingston, 2009; Nguyen, Boling, Levine and Shultz, 2009) given the weight-bearing function of the lower extremity. Our photographic assessment of the Q-angle in standing was associated with better reliability of measures than reported in the review by Smith, Hunt and Donell (2008), consistent with studies utilizing photogrammetry for this purpose (Moncrieff and Livingston, 2009; Santos, Silva, Sanada and Alves, 2009). Hence, photographic assessment of Q-angles might be considered as a viable and more reliable alternative to goniometric assessment in a clinical context, and does not require marker placement for acceptable reliability.
Lower extremity injuries in U.S. national fencing team members and U.S. fencing Olympians
Published in The Physician and Sportsmedicine, 2022
Kamali Thompson, Gregory Chang, Michael Alaia, Laith Jazrawi, Guillem Gonzalez-Lomas
Additionally, women reported lower IKDC and HOS scores and a vast majority of the hip injuries. It has been shown in several sports, female athletes have more hip and knee injuries than males because anatomical differences in the pelvic area evoke different mechanical responses [28,29]. An increased Q angle increases femoral anteversion and the angle of knee valgus, putting female athletes more at risk for patellofemoral injuries or knee injuries in general [28,30–33]. Our study did not obtain measurements to help determine a relationship between lower extremity anatomy and fencing injuries. Future studies could explore a possible correlation.