PATIENT EVALUATION

A.     Subjective:

•    Patient complaint

•    Location

•    Onset and duration of symptoms (insidious or traumatic)

•    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 formal treatment

•    Other medical problems

•    Concurrent medications and allergies

•    Functional or athletic demands

B.     Objective (also compare with uninvolved knee and

leg):

1. Inspection:

•    Redness, swelling, warmth

•    Scars

•    Gait Pattern

•    Arches

2. Palpation:

•    Medial, lateral, proximal and distal, posterior knee including popliteal fossa, locate point tenderness

•    Differentiate nodules, which may indicate Baker's cyst

3. Mobility:

•  Active and passive ROM (flexion, extension)

4. Muscle Testing:

•  Test patient prone: resist knee flexion-biceps
femoris test with leg externally rotated;
semimembranosus and semitendinosus test with
leg internally rotated. Additionally, test
quadriceps, abductors and adductors.

5. Provocation Tests:

•  Palpation of biceps femoris. semitendinosus.
semimembranosus tendons from origin to
insertion

6. Other joints:

•    Test ankle and hip for secondary involvement

•    Pain from the hip, low back, foot or ankle may refer to the knee

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

C.     Assessment:

1.    Problem list

2.  Goals

3.    Treatment:

 

•    Iontophoresis (medications, dosages, electrode size)

•    Rest

•    Other modalities (e.g.. ice or heat, stretching. friction massage, elastic supports, electrical stimulation, home program, activity or sport re­education to prevent re-injury, etc.)

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

•    Pain free exercise when increasing loads may be safely applied

D.     Plan:

1.    Frequency and duration of treatment

2.    Dates for assessment of progress

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