knee pain

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knee pain - November 19, 2007 6:06:13 PM

jsalva

Posts: 50
Joined: December 22, 2005
Status: offline

I have a pt - 15 y/o female with (R) lateral knee pain and "locking"; neg MRI; (R) hip and knee weakness; ROM WNL (some end range pain in flex); recurvatum and valgus; diffuse tenderness to palpation; + Thessaly test; no ligament deficiency; minimal tightness ITB/HS/quad; moderate fibrosis with ASTYM.

Episodes of locking occur in a flexed position. Pt had one episode of locking in clinic...was able to reduce with distraction and rotation mob in flexion (meniscus).

Any suggestion an the mechanism if the meniscus is not the culprit? Any advise for treatment other than closed chain strengthening and flexibility?

Thanks for all of your help, and have a great holiday!

John

Post #: 1

RE: knee pain - November 20, 2007 2:08:36 PM

Alex Brenner PT MPT OCS

Posts: 1057
Joined: February 29, 2004
From: Kentucky
Status: offline

John,
Based on what you wrote above it seems to me that this patient does indeed have meniscal pathology. Remember, the MRI does not have 100% diagnostic accuracy especially in the case of meniscal tears. For some reason I remember reading that the MRI has less than 70% accuracy for meniscal pathology when comparing it to the gold standard of arthroscopy.

Continue to treat her but if she is no better in a reasonable amount of time I would give an ortho surgeon a call. I think you have enough findings to substantiate that.

(in reply to jsalva)

Post #: 2