Kneed to Know
Differentiate between genu varum and genu valgum
genu varum: Bow-legs
genu valgum: Knocked knees
Define thompson test including positive and negative signs
To test for possible achilles tendon rupture/tear
have patient laying prone on the exam table, lift leg to 90 degrees in a flexed position, squeeze the calf muscle
Positive= no spontaneous plantar flexion of the foot
Negative= spontaneous plantar flexion of the foot
Describe the physical exam findings suggestive of posterior tibial tendinitis
tenderness along posterior medial malleolus on palpation
To test for stability of the anterior talofibular ligament
Have patient ankle joint at 20 degrees off the exam table in planar flexion. Examiners one hand is stabilizing the the anterior aspect of the distal leg. The other examiners hand is cupping the calaneus pushing upwards
Positive= if the anterior tibia pulls forward more than the other side
Negative= same bilaterally
Identify the ligaments of the knee and which bones they connect to
1. ACL-proximal femur to distal tibia
2.PCL-medial condyle of femur to posterior tibia
3.MCL-medial epicondyle of femur to medial condyle of tibia
4.LCL-lateral epicondyle of femur to fibular head
Define the talar tilt test including positive and negative signs
test for the integrity of the talocalcaneal joint.
Stabilize the ankle with one hand, grasp the heel with the other, and invert and evert the foot by turning the heel inward then outward
Positive= excessive movement or lack of a hard end point suggest injury to the anterior talofibular ligament
Describe Lachman's test including positive signs and negative
Tests for laxity or rupture of the ACL. Knee is at a decreased angle to reduce pain. Positive= laxity or tear, Negative = no laxity or tear
Describe the physical exam findings suggestive of plantar faciitis
Focal heel tenderness of facia posterior and inferior of calcaneus on palpation
Identify physical examination findings of acute gouty arthritis
Very painful and tender, dusky red swelling that extends beyond margin of the joint
Describe the valgus test including positive and negative signs
To test for laxity or tear of the MCL. Positive= laxity or tear of MCL, negative= No laxity or tear
Describe anterior drawer test including positive signs and negative signs
To test for laxity of rupture of the ACL. Positive sign would be laxity or rupture. Negative would be no laxity or rupture/tear
What are the ligaments of the ankle
Bonus: which ligament has the highest risk of injury with eversion?
Lateral: Anterior talofibular, talocalcaneo ligament, posterior talofibular
Anterior: Deltoid ligament
Bonus: Anterior talofibular
Describe apley grind test including positive and negative signs
To test for possible meniscus tear
Have the patient lying prone with their affected knee flexed at 90 degree angle. Examiner places own knee across the patient posterior thigh and pushed down on heel of foot while twisting the leg.
Positive= pain on twisting
Negative= no pain
Describe posterior drawer test including negative and positive results
Tests for PCL laxity or rupture. Positive= PCL laxity or tear, Negative= No PCL tear or rupture
Identify physical examination findings of corn
Painful thickening of skin that results from recurrent pressure on normally thin skin. characteristically occur over bony prominence such as fifth toe
Identify physical examination findings of ingrown toenail
Sharp edge of the toenail may dig into and injure the lateral nail fold, resulting in inflammation and infection. tender, reddened, overhanging nail fold
Identify physical examination findings of callus
area of thickened skin that develops in a region of recurrent pressure, usually on the sole of foot and is painless
Describe varus stress test including positive and negative signs.
Test for LCL laxity or tear. Positive= laxity or tear of LCL, Negative= No laxity or tear
Identify physical examination findings of hallux valgus (Bunion)
Lateral deviation of the great toe and enlargement of the head of the first metatarsal on medial side
Describe Thessaly test including positive and negative signs
To test for possible meniscus tear
Have the patient stand and hold onto to you. Have them lift up the unaffected leg while slightly bending the affected leg. Have patient twist left to right 3 times on affected leg
Positive= pain with twisting movement
Negative= no pain with twisting
Identify physical examination findings of hammer toe
Usually involving the second toe, hyperextension at the metatarsophalangeal joint with flexion at the proximal PIP joint
Define McMurray test including poaitive and negative signs
To test for posible meniscus tear.
Positive= if a click is felt or heard at the joint line during flexion and extension of the knee, or if tenderness is noted along the joint line
Identify physical examination findings of plantar wart
hyperkeratotic lesion caused by HPV located on the sole of the foot. Characteristic small dark spots give a stippled appearance
Describe patellofemoral grind test including positive and negative signs
Patient supine and knee extended, compress the patella against the underlying femur, and gently move medially and laterally.
Positive= pain and crepitus with test or using stairs
Negative= No pain or crepitus
Identify physical examination findings of morton neuroma
look for tenderness over the plantar surface between the third and fourth metatarsal heads. Check for pain radiating to the toes when you press on the plantar interspace and squeeze the metatarsals with other hand.