ACL tear?

RehabEdge Physical Therapy Forum

Forums Register Login Forgot Login? My Profile
My Subscription My Forums Photo Gallery Member List
Search Calendars FAQ Ticket List Log Out

ACL tear?

Logged in as: Guest

Users viewing this topic: none

Printable Version

All Forums >> [RehabEdge Forum] >> Orthopedics >> ACL tear?

Page: [1]

Message

<< Older Topic Newer Topic >>

ACL tear? - July 16, 2007 4:28:28 PM

chad33

Posts: 5
Joined: March 6, 2007
Status: offline

I just finished evaluating a 29 yo female with complaints of an insidious onset of R knee popping when squatting, kneeling, or extending knee out of a crossed leg position. She denies any pain, swelling or trauma to the joint, her symptoms began 2 mo ago.
Xray -
PMHx non contributory gave birth 8/14/06
Exam
MMT 5/5 RLE
Lachmans Ant drawer mild increased laxity vs L

I was able to eliminate popping by applying an AP mob to proximal tibia while she squatted. Any possibility it is an ACL tear without trauma??? Let me know your thoughts please

Post #: 1

RE: ACL tear? - July 16, 2007 5:23:57 PM

Tom Reeves DPT ATC

Posts: 470
Joined: March 14, 2006
Status: offline

I would say it sounds unlikely just based upon the mechanism of injury. It sounds more like a meniscal injury (tear or a "catch" where part of the meniscus may have flipped out of position). I recently learned of a new (new to me anyway) meniscal test that has a high specificity and sensitivity the Thessaly test. You can probably google it and get a picture with better directions than I could write.

Good luck.

(in reply to chad33)

Post #: 2

RE: ACL tear? - July 16, 2007 6:01:43 PM

jlharris

Posts: 478
Joined: April 12, 2006
From: Nebraska
Status: offline

The Thessaly is a nice test for those that can tolerate wt bearing (ie non-acute). I also agree that it sound meniscal to me. A meniscus tear is often asymptomatic and can rear it's head by demonstrating the symptoms you described after doing a common task (eg squating).

If you decide it is a meniscus lesion, don't be to quick to ship her off to the orthopod. As it was an insidious onset, it can likely respond to conservative treatment and return to being asymptomatic.

FYI - here is the citation for the Thessaly test:

Karachalios T, et al. Diagnostic Accuracy of a New Clinical Test (The Thessaly Test) for Early Detection of Meniscal Tears. J Bone & Joint Surgery. Vol 87-A(5) May 2005: 955-962

_____________________________

Jason L. Harris, PT, DPT
My PT Blog

(in reply to Tom Reeves DPT ATC)