Question

A collegiate gymnast reports to the athletic training facility complaining of right knee joint line pain. The pain has been present for 2 days, but the athlete cannot recall any specific time when the injury occurred. The athlete reports a 4/10 pain that is accompanied with clicking and giving way. The athlete has not done anything for the injury at this point. The athlete does report a previous history of intermittent knee pain.

1.Based on the information provided, what are your immediate concerns?

2.Is there any other information that you would like to know?

3.What special testing would you include in your initial evaluation? Why? Do you expect any barriers to performing any of these special tests?

4.What do you expect to be your clinical diagnosis? What about your differential diagnosis? Why?

5.Would you recommend any diagnostic techniques? Do you feel this athlete needs to be referred? If so, when? Explain.

Answer 1

1.Based on the information provided, my immediate concrrn is right knee joint meniscal tear..

2.Complete history and physical examination is necessary .Knee pain can have causes that aren't due to underlying disease. Examples include heavy physical activity, lack of use, injuries such as sprains or strains, sitting in a constrained area or sitting on knees for a prolonged period.

3.Mc murrays test& Thessaly tests are two meniscal injury diagnostic physical tests.

The knee is brought to full extension while maintaining rotation. A positive test produces a pop or click. Pain in a reproducible portion of the range of motion is described as part of McMurray's test

The Thessaly Test
With the patient standing facing you, hold the patient’s outstretched hands while they bear weight on their affected leg only.2 The patient then flexes their affected knee to 20°, internally and externally rotating their body 3 times, using their knee as the pivot point. The test is positive if there is reproducible pain in the knee upon rotation . The test can be repeated with the knee at 5° of flexion, as well as on the opposite leg for comparison.

Muscle guarding by patient may be leads to false result inboth tests.

4. Clinical diagnosis is most probably medial or lateral meniscalninjury. Other differential diagnoses are ACL &PCL injury, Osteo arthritis, Sprains,tendenitis, patellofemoral syndrome etc.

5. MRI is tge conformatory test for meniscal injury. This patient to be reffered if his symptoms worsons with time . &needs surgical correction and rest