Tib-Fib Subluxation
test tibial rotation first
13 year old boy had pain and is overweight; has posterior-inferior rotation in hip
SCFE (adolescent coxa vara
Synovial plica
Quad imbalance, patella alta/baja, synovial plica syndrome (ALL)
pain on prolonged sitting
housemades knee
pre-patellar bursitis
segond’s sign
lateral tibial avulsion Fx- ACL and MM
sindig larsen/ johansson disease
pelligrini steati
calcified MCL
godfrey sag
PCL tear/instability
45 male had sudden pain; reports a painful sense of giving way (mechanical); anterio-medial joint line pain; sharp pain and catching; pain increased with activities; irritation of synovium
-Orthopedic test: McMurray’s
Most likely clinical impression:
-Medial Meniscus Tear
Management avenues
-Obtain x-ray based on Ottawa Rules (couldn’t bend knee)
-Recommend crutches and co-manage with orthopedist
45 year old female, insidious Right Lateral knee pain; pain aggravated by running downhill training for marathon; no pain with walking; pain with stair climbing; crepitus over lateral knee
-Orthopedic + Tests: Noble Test, Modified Ober’s
-Clinical Impression
a. IT Band syndrome
Management:
a. Stretch IT band, hamstrings and quad
b. Adjust for fibular head subluxation
c. Adjust for internal hip rotation
d. Adjust talus and calcaneus bones if needed
OsteoSARCOMA
adult patient with relatively painless activity, has a feeling of giving way
ACL instability
athletes who experience sudden pain and inability to plantarflex toes to push off
tennis leg
ottawa rules:
high ankle sprain characterized by:
syndesmosis of tib-fib lig
osteochondrosis, navicular pain, may lead to AVN
kohler’s
not considered an ottowa rule
excuisite pain at 2nd met head
21 male, diffuse heal pain, bohler’s angle 4o
calcaneal fx
typically affecting juveniles, posterior heel and calf pain, can lead to AVN
severs
west pont ankle pain, ATFL and CFL instability
grade 2