Specialists

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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 […]

Palpation of the extensor mechanism

This is performed on an extended knee.First the muscular structures are ascertained. Ask the patient to extend the slightly bent knee and resist the movement.This movement usually outlines the vastus medialis, vastus lateralis, rectus femoris and the patellar ligament. Then the patellar border with its tendinous insertions are palpated. With the hip in flexion and […]

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 […]

Traction tendinitis

Sinding-Larsen-Johansson disease

Sinding-Larsen-Johansson disease is a traction tendinitis of the distal pole of the patella, caused by microtrauma. It is seen in growing individuals; who have pain at the inferior pole of the patella in association with running and jumping. Typical clinical signs are point tenderness at the inferior pole of the patella, swelling, limitation […]

Knee extension mechanism injuries

The knee extension mechanism includes the quadriceps muscle-tendon, the patellar bone, the patellar tendon, and its insertion into the tibia. Injuries can occur in all these structures.

Quadriceps tendon injuries The distal quadriceps tendon attaches to the patella and its adjacent soft tissue structures (the retinaculum). It is important for the extensor mechanism. This tendon […]

Knee

The knee is the most frequently injured joint in athletics.Most injuries are due to the extreme stresses of twisting and turning activities such as those found in skiing, soccer, and American football. Medial collateral ligament and meniscal injuries are in the majority, but anterior cruciate ligament ruptures are also common and are responsible for a […]

Prepatellar Bursitis

SYMPTOMS

There is gradual or acute onset of localised swelling and inflammatory signs over the patella.

AETIOLOGY

The bursitis can develop from a direct trauma and bleeding or from repetitive stress, when synovial fluid fills the bursa (housemaid’s knee) or when pus from infected superficial skin wounds penetrates the bursa.

CLINICAL FINDINGS

There […]

Stress Fracture

Basics Description A stress (microscopic) fracture occurs when: Repetitive stresses are applied to a bone faster than it is able to remodel to withstand this challenge. As the stressing force continues, the bone gradually fatigues and eventually breaks. Remodeling occurs in response to the stress but does not happen quickly enough to prevent the […]

Platelet Rich Plasma Injection Grafts for Musculoskeletal Injuries: A Review

Abstract

In Europe and the United States, there is an increasing prevalence of the use of autologous blood products to facilitate healing in a variety of applications. Recently, we have learned more about specific growth factors, which play a crucial role in the healing process. With that knowledge there is abundant enthusiasm in the application […]

Patellar Subluxation and Dislocation

The patella, or kneecap, is one of three bones that come together at the knee joint. All of these bones have a layer of cartilage at points where their surfaces come into contact. The patella is also enveloped by a tendon. This tendon connects the quadriceps muscle of the thigh to the shin bone (tibia) […]