Bilateral knee sprain
Patient complain of pain over left knee joint .
Nature of pain : throbbing pain Clinical reasoning According to Nicola J. Petty in neuromusculoskeletal ,page 11 throbbing pain suggest vascular structure involve .
Relationship of symptoms No other related symptoms .patient does not complain any back pain or other body part involve .
Aggravating factors
Walking , climbing up stairs and squatting Anterior knee pain which aggravated by climbing up stairs may implicate patellofemoral joint ( Bretcher & Powers 2002 ),where as posterior knee pain aggravate by squatting may implicate the menisci (McDermott 2006 )
Severity
VAS : 7/10 The pain is severe as due to pain is so intense in certain point of range provokes pain and and the pain is so intense that…show more content… Both the slump and SLR also provoke pain in presence of a lumbar disc herniation due to traction of the involved nerve root.
Slump: The patient is seated with the back straight and looking straight ahead. The patient is then asked to “slump”, fully flex the neck and then extend one knee while dorsiflexing the same foot. Reproduction of symptoms is a + test and sciatic nerve tension. Sensativity:83%, Specificity: 84% (values for indicating lumbar root compression due to disc herniation).
SLR Test
SLR: The patient lays supine. Keeping the knee fully extended, the examiner flexes the patient hip until reaching full flexion or until the patient experiences discomfort. The angle of hip flexion is then measured. A SLR test stretches the L5&S1 nerve roots 2mm-4mm so when positive, indiciates a lesion of L5/S1. This will occur during the first 70 degrees of flexion. Past 70 degrees of flexion, tension is placed on the sciatic outside of the spinal canal. Sensativity: 52% Specificity: 89% (values for indicating lumbar root compression due to disc