Knee HOPS

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Knee HOPS
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HISTORY

• We estimate that the proper diagnosis can be
  achieved in 80 - 85 of cases from a properly
  performed history alone. (Univeristy of Minnesota
  Sports Medicine)
• How
• What sport
• Contact v. non-contact
• Non-contact think ACL
• Valgus force think MCL
• Varus force think LCL
• Rotational force think meniscus or ACL

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• Did it feel like it gave out
• Did you hear or feel a pop
• Chronic v. acute onset
• Functional limitations
• Locks think meniscus
• Pain with deep knee bends or stairs think meniscus

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OBSERVATION

• It is important to observe the symptomatic knee
  for any deformities, abnormal alignment, surgical
  scars, lacerations, discoloration and swelling.
• Observe the gait
• Unable to extend knee fully when walking think
  ACL
• Knee locked when walking think meniscus

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• Swelling
• Intraarticular swelling inside the joint
  (capsule) will result in the loss of the normal
  contour of the extensor mechanism. May see a
  fluid wave think meniscus, ACL or PCL

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• Extraarticular swelling oustide of the joint.
  Localized swelling and a traumatic etiology can
  indicate either a localized hematoma or a
  localized joint injury.
• Medial aspect of knee think MCL
• Lateral aspect of knee think LCL
• Anterior aspect think bursitis, tendonitis
• Tibial tuberosity think Osgood-Schlatters
• Posterior aspect think Bakers

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PALPATION

• Bony
• Head of fibula think LCL
• Tibial tuberosity think Osgood Schatters
• Joint line/tibial plateau- think meniscus
• Patella inferior pole think Lars-Johansen

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• Muscular
• Quadriceps and quadriceps tendon
• Hamstrings and tendons
• Origin of gastrocnemius
• Ligaments
• MCL on medial side
• LCL on lateral side
• Cannot palpate ACL or PCL

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Special Tests

• ROM active,passive and resistive knee flexion
  and extension
• Patellar grind test-- chondromalaysia