Osteoarthritis of Knee

Diagnosis

  • Bilateral symmetrical tricompartmental osteoarthritis of the knees
  • With 20 deg flexion deformity with further flexion upto 90 deg
  • With 30 deg varus deformity
  • With varus instability
  • in a 60 year old retired postman
  • disabled due to pain, difficulty sqauatting & using stairs

History

  • mechanical pain
  • grating sensation with movement
  • progressive bowing
  • clicking, locking
  • disability-squatting/walking, cross-leg sitting/stairs
  • treatment taken-supervised physiotherapy
  • Ask for intermittent claudication ( associated lumbar canal stenosis)

Examination

  • Bilateral varus deformity of 30 deg
  • tenderness at medial & joint line & at margins of patella
  • osteophytes are palpable at joint line
  • local temp not raised
  • knee joint effusion: patellar tap+ cross fluctuation+
  • synovial hypertrophy+
  • patellar glide painful
  • patellar grind test +
  • normal patellar tracking
  • ROM: 20 deg flexion deformity , further flexion to 90 deg
  • entire range painful with crepitus
  • extensor lag of 20 deg
  • varus laxity ++
  • McMurray's test -
  • thigh wasting of  2 cm
  • popliteal fossa normal to examination
  • no distal neurovascular deficit
  • opposite knee: as mentioned
  • Hip, spine, 1st carpometacarpal joint normal

0 comments:

Post a Comment

Subscribe to: Post Comments (Atom)