CHIR12007 Week 10 Synopsis – May 20 – May 24, 2020

Differential Diagnosis Medial Collateral Ligament Sprain Verses Chondromalacia

Medial Collateral Ligament Chondromalacia Patellae
Sprain Syndrome
History Questions - Age? - Are there any
- Is it trauma or non-trauma repetitive
related? movements?
Where is the pain? - Does your knee
- Type of activities they are ache?
doing. - Any pain when
standing after being
Injury related seated for long
- Was the injury involving periods?
valgus forces? - Any Crepitus?
- Does the knee lock or - Any pain when
catch? ascending or
- Anything that aggravates descending stairs?
the condition?
- Condition improving,
worsening or staying the
same?
- Usual activities?
- Past medical and/or
surgical history?
- Previous injury?

Non injury related

- Does the pain come on
after walking, jogging or
other activity?
- Does swelling develop in
the knee?
- Does it grate when you
move?
- Does the pain come on at
rest and is there morning
stiffness?

Observations - Superficial tenderness & - Cartilaginous ache

inflammation type of pain
- Slight effusion

Active Movements - Restriction in full extension - Repeated extension

- Difficulty bending the knee of the knee from
flexion will produce
pain and a grating
feeling underneath
the patella, especially
 if articular

Passive - Grade of the injury will - Extension of knee

Movements depend of the degree of
pain or on the range of the
opening of the joint space
during stress tests of the
patients knee joint.

Resisted Isometric - Flexion, Extension, Ankle - Flexion, Extension,

Movements dorsiflexion and plantar Ankle dorsiflexion and
flexion (Gastrocnemius) plantar flexion
(Gastrocnemius)
Special Tests - Valgus stress test - Squat Test
- McMurray’s test - Thessaly Test
- Apleys compression Test - Stroke Test
- Lachmann test for ACL - Patellar Grind Test
stability - Step Test
- VMO stabilization test
- McConnel’s Test
Sensation Dermatomal Tests (L4, S1, S2) Dermatomal Tests (L4, S1,
S2)
Reflexes Patellar tendon reflex Patellar tendon reflex
Joint Play Patella Femoral, Tibial Femoral, Patella Femoral, Tibial
Movements Posterior glide of tibia, Posterior Femoral, Posterior glide of
glide of femur on tibia tibia, Posterior glide of
femur on tibia
Diagnostic MRI MRI
Imaging

Management Plan:

- 6 week management plan

- 1st reassessment after two weeks
- Another reassessment after completion of the management plan
- Nutrition
- Reasons for presenting now
- Lifestyle, movement habits (active care plan)
- Posture hygiene
- Water activities
- PIR
- Mobilisation soft tissue work
- Stretching exercises PNF
- Trigger points therapy work (correction of factors that perpetuate trigger points)
Test INTERPRETATION/WHAT TISSUE STRUCTURE DOES THIS TEST
LOAD? For you to complete

Anvil Test Hip pain, arthritis, femoral neck or head fracture.

Scour Test Hip quadrant test that is a passive test used to assess if the hip is the
source of the patients symptoms.

Ober’s Test Evaluates if there is a tight, contracted or inflamed Tensor Fasciae

Latae (TFL) and Iliotibial band (ITB)

Lachman’s Test Passive accessory movement test of the knee performed to identify
the integrity of the anterior cruciate ligament (ACL)

Apley’s Grind Used to evaluate individuals for problems of the meniscus in the knee
Test

Thessaly Test Screening tool for meniscal tears/lesions, reproduction of joint loading
in the knee with meniscal tear will produce the same symptoms the
patient reported.

Anterior Drawer Tests the stability of the knee’s anterior cruciate ligament (ACL) used
Test to determine if the person has injured their ACL.