PATIENT EVALUATION

A.     Subjective:

•    Patient complaint

•    Location

•    Onset and duration of symptoms

•    Description of symptoms (i.e., numbness, pain [constant, dull, sharp] hypersensitivity, stiffness); use pain scale

•    Pattern of when symptoms occur (AM, PM, after activity, etc.)

•    Self-help or other formal treatment

•    Other medical problems

•    Concurrent medications and allergies

B.     Objective (also compare with uninvolved knee):

1.  Inspection

•    Redness, swelling, warmth

•    Scars

•    Gait pattern

•    Arches

2. Palpation:

•    Medial lateral, proximal, and distal patellar tendon. Locate point tenderness.

•    Differentiate nodules, which may indicate Osgood-Schlatter's disease.

3. Mobility:

•  Active and passive ROM (flexion, extension)

4. Muscle Testing:

•  Quadriceps, hamstrings, abductors and adductors.

5. Provocation Tests:

•  Palpation of patellar tendon from origin to
insertion.

6. Other Joints:

•  Test ankle and hip for secondary involvement.

7. Review x-ray films and physician's report.

C.    Assessment:

1.     Problem list

2.  Goals

3.  Treatment:

•    Iontophoresis (medications, dosages, electrode size)

•    Other modalities (e.g., ice or heat, stretching, friction massage, arch supports for longitudinal arch, home program, activity or sport re-education to prevent re-injury, etc.)

•    Oral or injectable medications (administered by physician, e.g.. NSAIDs. corticosteroids)

D.     Plan:

1.     Frequency and duration of treatment

2.     Date(s) for assessment of progress.

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