Knee and Patella Pathologies
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| Patellar Dislocation | Occurs when the patella slides out of place; dislocation of the patella.
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| Patellar Dislocation Identifying Information | Pain in the medial joint capsule, vastus medialis, and beneath the patella. MOI: valgus blow to knee; rapid change of direction. Obvious deformity w/ patella positioned laterally with knee flexed. Displaced patella. ROM isn't performed due to dislocation.
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| Patellar Dislocation Identifying Information Cont. | Special Tests: (+) Apprehension Test post reduction. Not used if dislocation was known to have occurred.
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| Patellar Dislocation Differential Diagnosis | Patellar tendon rupture, fracture of posterior aspect of patella or lateral femoral condyle.
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| Patellar Fracture | Fracture of the patella.
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| Patellar Fracture Identifying Information | Acute onset; pain arising from the patella. Swelling over and around the patella. AROM: extension lag of 10-30; MMT: decreased quad strength; PROM flexion limited by pain.
Special Tests: Not Applicable
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| Patellar Fracture Differential Diagnosis | Patellar tendon rupture, quadricips tendon rupture, patellar dislocation.
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| Meniscal Tears | Tearing in the Lateral Meniscus or Medial Meniscus.
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| Meniscal Tears Identifying Information | Knee "giving out," knee clicking, pain and crepitus along the joint line, meniscal cyst. AROM: decreased PROM: pain in flexion and extension MMT: unremarkable
Special Tests:McMurray's, Apley's Compression, & Thessaly
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| Meniscal Tears Differential Diagnosis | Patellofemoral joint dysfunction, synovial plica irritation, osteochondral defect, instability.
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| Iliotibial Band Friction Syndrome | Friction caused by the IT band and the lateral femoral epicondyle rubbing together.
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| Iliotibial Band Friction Syndrome Identifying Information | Pain over the lateral femoral condyle. Genu varum, leg-length discrpancy. AROM: w/in normal limits MMT: TFL may be weak PROM: w/in normal limits
Special Tests: Noble's compression Test, Ober's Test.
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| Iliotibial Band Friction Syndrome Differential Diagnosis | Lateral meniscus tear; biceps femoris tendinopathy; patellofemoral dysfunction; popliteus tendinopathy.
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| Tibiofemoral Joint Dislocation | Dislocation of the tibia from the tibiofemoral joint.
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| Tibiofemoral Joint Dislocation Identifying Information | Severe diffuse pain about the knee, obvious deformity of the joint, swelling and discoloration, ROM is contraindicated.
Special Tests: Avoided in presence of a dislocation.
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| Tibiofemoral Joint Dislocation Differential Diagnosis | Femoral Fracture, tibial fracture.
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| ACL Sprain | Stretching or tearing of the anterior cruciate ligament.
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| ACL Sprain Identifying Information | Pain within the knee joint, pain with AROM, pain and limitations with MMT, and pain is likely with PROM.
Special Tests: Lachman's test, Anterior Drawer Test, Prone Lachman's test.
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| ACL Sprain Differential Diagnosis | PCL sprain, meniscus tear, hamstring strain, strain of the gastrocneius origin, osteochondral fracture, patellar dislocation.
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| MCL Sprain | Stretching or tearing of the medial collateral ligament.
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| MCL Sprain Identifying Information | Pain in the medial portion of the knee, caused by a calgus force, over time edema may occur, palpation will reveal tenderness along the length of the MCL. AROM: pain and decreased ROM; MMT:decreased flexion and extension; PROM: pain and loss of ROM.
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| MCL Sprain Identifying Information Cont. | Special Tests: Slocum drawer test
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| MCL Sprain Differential Diagnosis | ACL, PCL, medial meniscal tear, semimembranosus strain, pes anserine strain, pes anserine bursitis, common peroneal neuropathy, distal femoral epiphyseal fracture.
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