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Examination of Knee Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
The “bulge test” is useful with smaller effusions. The fluid is milked from the medial to the lateral side using the thumb on one side of the patella and then quickly pressing the lateral side with the opposite thumb. The medial parapatellar region “fills out” after pressure on the lateral parapatellar region (positive “bulge sign”). This is indicative of knee effusion. With larger effusions, the suprapatellar space is filled up and “suprapatellar fullness” is felt. The patella is pushed anteriorly by the fluid. In a straight knee position, the fluid in the suprapatellar pouch can be pushed down by one hand into the lower compartments. With the opposite fingers, the elevated patella can be pushed against the femoral condyles and a palpable bounce can be felt. This test is known as the patellar ballottement test or patellar tap test.
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).
The knee joint
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
Simple analgesia, taken either prior to activity or on a regular basis, can be supplemented by topical NSAIDS or capsaicin. The use of oral NSAIDs remains controversial, but short-term use can assist in limiting an acute exacerbation. A knee effusion caused by trauma, degenerative change or inflammatory arthritis can be assisted by use of cold packs.
An algorithmic approach to rehabilitation following arthroscopic surgery for arthrofibrosis of the knee
Published in Physiotherapy Theory and Practice, 2018
This 46-year-old female tore her left ACL after sustaining a noncontact knee injury while skiing. She underwent a bone patella bone autograft and followed a standard postoperative ACLR rehabilitation protocol. After an initially uncomplicated postoperative course of care, the patient developed increased pain and left knee effusion at 8 weeks postoperatively. Left knee extension ROM was measured at 8° shy of full extension with a firm end feel noted. Temporary improvements to her knee extension ROM were measured following manual therapy and passive knee extension stretching, but knee motion gains were not maintained between physical therapy sessions. At 10 weeks postsurgery, 20 cc of bloody fluid was aspirated by the orthopedic surgeon from the patient’s left knee. An MRI of the left knee revealed an intact ACL graft, moderate joint effusion, and an area of intraarticular arthrofibrosis anterior to the anterior cruciate ligament graft. The patient underwent arthroscopic knee surgery for debridement of the arthrofibrosis. She was referred to physical therapy immediately postoperatively but due to a planned vacation, did not initiate formal treatment until 1 month after her procedure.
Osteochondritis dissecans of the patella: a case-report in a juvenile football player
Published in Science and Medicine in Football, 2021
Patrícia Cruz, Filipe Bettencourt, Gonçalo Arneiro
There was no history of traumatic injury and there was no associated pain. Clinical examination revealed a right knee effusion, without evidence of ligamentous laxity and a full range of movements was preserved. No abnormality was identified on routine blood investigations. Arthrocentesis was made and synovial fluid has no macroscopic changes. A week of PRICE (Protect, Rest, Ice, Compression and Ice) was prescribed. After that, he started with isometric exercises and bike training and after 2 weeks he was available to return to play.
A case of enteropathic arthritis complicated by superimposed bilateral septic arthritis of the hips
Published in Modern Rheumatology Case Reports, 2021
Matthew Colquhoun, Arpita Roy, Othman Kirresh, Maria Mouyis
On admission, she was drowsy, having received sedative and analgesic medication for pain from the ambulance service. Cardiovascular, respiratory and abdominal examinations were unremarkable. She was tachycardic (126 bpm) and pyrexial (T 39.1 C) with a normal blood pressure and lactate. She had significant pain on internal and external rotation of the hips (worse on the right) with inability to tolerate passive movements or straight leg raise. There was a small right-sided knee effusion.