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I personally focus more on assessing before diagnosing because i have noticed many of the reliable tests require very precise movements to be reliably done and having the patient load we do in our hospital we need to be more efficient with time so I do perform only the tests that are marked as reliable but i still don't sometimes kick out the possibility.
What is the difference between meniscus and fat pad with these tests?? i have presented with meniscus injury for 9 months, physio doone all tests needed and agreed it was meniscus, mri scans shows slight meniscus tear also. But when suregery was done, i was told there was no tear and it was fat pad. can these symptoms be similar?? can an mri scan be wrong. Physio said i showed no symptoms of fat pad injury at all. Im very confused as is my physio with my surgeon's diagnosis. Any advice you can provide would be very helpful.
1 query if pt falls out of 58% and clinicians not able to find out any injury but pt still complaints of pain BT i dont want to send pt for an MRI what should be my next and immediate plan..
Rule out any sinister pathology. This should always be the first step. We will never diagnose a torn meniscus. We can have a suspicion and may confirm With imaging. Unless there is severe locking of the knee, the recommendation remains conservative treatment.
I studied that compression + external rotation is positive for internal meniscus, and compression + internal rotation is positive for external meniscus, you didn't explain that. Am I wrong?
External rotation stresses the posterior portion of the medial meniscus and the anterior portion of the lateral meniscus. Internal rotation stresses the posterior portion of the lateral meniscus and the anterior portion of the medial.meniscus.
This could be an indication yes, but the Apley test has rather weak clinical value. Have you had a trauma with a flexed knee and rotation? Swelling in the back of the knee (Baker's cyst)? Other things that might be indicative for a meniscus lesion could be: - Limited flexion and/or extension - Joint Line Tenderness - Locking sensation of the knee - Positive McMurry Test
Physiotutors No i didn't had that kind of trauma . I was doing back flip when i firs injured my knee and when i touched the ground the knee went in , so the weight went to the extern menisque , with some training the pain pased , lately i injured again the kne but this time hapend the oposit the knee went from in-out and the pain is back , now it feels like something is detached , thats why im confused! Thank you
hi! i have a quick question. last june i fell and all my weight went on my knee and felt two pops. first thought it was my meniscus so i got an MRI. my doctor said the ligaments connecting my patella were stretched/strained pretty bad so i most likely only dislocated my knee and that it popped in on its own. i’m a catcher in baseball and i’ve played since the injury but it’s been some what unstable. i get instability still in my knee & pain. sometimes it shoots down into my shin, or sits where it originally did on the left side under my kneecap. i don’t know if i need to continue to strength my knee, or if some how the MRI could have missed a partial tear? thanks and i’m looking forward to a reply! (:
+abhay kumar we have performed the appley test according to it's original description in the video. Joint line tenderness is another separate test for meniscus lesions.