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Evidence-‐Based Examination of the Knee and Thigh Practice Session & Skills Check-‐offs
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Evidence-‐Based Examination of the Knee and Thigh Presented by Eric Hegedus, PT, DPT, MHSC, OCS, CSCS Practice Sessions/Skill Check-‐offs
Chapter Four: Triage and Screening (40 minutes CEU time)
Skilled Process
Review in
Chapter
Photo Description Check Off
Perform a full Lower Quarter Screen
Slide 7
Dermatomes, Myotomes, Reflexes, UMN test (Babinski or clonus). Discuss interpretation of findings: What do findings of hypo-‐ or hyper-‐reflexia mean? What do findings of decreased sensation and decreased strength in the same dermatome/myotome mean? How about in changes in different combinations of dermatomes, myotomes, reflexes? How would a brachial plexus injury present? May need to use PubMed to discover these answers
Performance the Beighton Index and review the Brighton Criteria
Slide 8
Hands to floor plus bilateral testing of thumb to forearm, elbow extensibility, knee extensibility, and little finger MCP extensibility. Discuss the major and minor Brighton criteria and requirements for diagnosis
The 2 accepted fracture rules at the knee
Slides 9-‐10
What are the requirements for both Pittsburgh and Ottawa and what is the diagnostic usefulness of each
Evidence-‐Based Examination of the Knee and Thigh Practice Session & Skills Check-‐offs
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Discuss the ACR clinical criteria for diagnosing knee OA
Slide 11 Are these criteria a screen for OA? What is the value of a positive finding? A negative finding? Calculate the likelihood ratios.
Perform the patellar-‐pubic percussion test
Slide 13
Place a stethoscope on the subject’s Pubic bone either right or left of midline (depending on side being tested) and tap the patella. A positive test for fracture is indicated by a muted sound on the involved side when compared to the uninvolved
Have the subject perform a squat
Slide 14
Discuss possible local contributors to knee pain in this test. Discuss potential proximal and distal contributors to a dysfunctional test.
Notes: