Specialists

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Small Proteoglycans of Articular Cartilage

Small proteoglycan molecules consisting of biglycan, decorin, and fibromodulin represent approximately 5% of the proteoglycan of articular cartilage. Dermatan sulfate proteoglycans were first observed in articular cartilage by Rosenberg in 1985. The small proteoglycans each consist of a protein core and glycosaminoglycan chain branches.

The core protein of the small proteoglycans is only one fourth […]

Synovial thickening

Synovial thickening is a vital c1inkal finding. It indicates primary inflammation of the synovia and differentiates this from a secondary synovitis.Synovial swelling is best detected at the medial and lateral condyles of the femur, about 2 cm posterior to the medial and lateral edges of the patella.

Here the capsule lies almost superficially,covered only by […]

Provocation tests for meniscal tears

Significance

These tests are used to detect, by demonstration of clicks and / or pain, meniscal tears in the absence of actual (sub)luxations. If clicks are detected, it is wise to examine the other limb as well in order to eliminate non-pathological clicks arising from tendons snapping over bony prominences.

Test I

Positioning.

The subject […]

SPECIFIC TESTS-Medial shearing

Significance

This test is used to detect internal derangement at the inner side of the knee. Pain on jerk is suggestive for a minor lesion at the tibial insertion of the anterior cruciate ligament.

Positioning.

The subject lies in the supine position with the knee flexed to a right angle, and the heel resting […]

Anterior drawer test in external rotation

Positioning.

The subject is positioned as for the previous test. The lower leg and foot are externally rotated as far as is comfortably possible.The examiner places both hands around the upper part of the tibia with the index fingers on the hamstring tendons and the thumbs at the anterior border of the joint .

Procedure. […]

Passive lateral rotation in prone position

The subject lies in the prone position with both knees flexed to a right angle. The examiner encircles both heels and performs a bilateral external rotation. The range of movement is assessed by the twisted position of the feet. This test may be decisive in comparing the range of external rotation.

Common pathological situations:

• […]

Palpation of the popliteal fossa

The borders of the lozenge-shaped popliteal fossa are formed by the gastrocnemii, the biceps femoris and the semitendinosus and semimembranosus muscles. The bottom is formed by the posterior capsule and the popliteus muscle .The popliteal fossa is covered by a fascia. The lozenge is vertically crossed (from lateral to medial) by: the tibial nerve, popliteal […]

Knee-Bony landmarks

All palpable bony parts of the knee are situated anteriorly. Palpation is performed with the subject in the supine lying position. The knee is either bent to a right angle or fully extended,depending on the palpated structure. In a flexed position of the knee, the patella can easily be outlined. In this position the large […]

Chondromalacia Patella

SYMPTOMS

There is gradual onset of diffuse exercise-induced pain around the anterior part of the knee. Prolonged sitting or squatting often trigger the symptoms (positive movie sign). Walking down stairs is more difficult than up.

AETIOLOGY

Chondromalacia means ‘soft cartilage’. The exact aetiology is unknown. The correct diagnosis must be identified, by arthroscopic probing, […]

A Patient’s Guide to Viscosupplementation for Osteoarthritis of the Knee

Introduction

The squeaky hinge gets the grease. In the same way, the joint that aches from osteoarthritis (OA) gets the attention. Since the knee works like a hinge joint, it makes sense that lubricating the joint might help people with knee osteoarthritis. Accordingly, a treatment called viscosupplementation has been used by doctors to restore lubrication […]