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MSK Lower Extremity Workshop

In Preparation for ECM3-4 Working Group
by

Ananya Gangopadhyaya

on 18 January 2018

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Transcript of MSK Lower Extremity Workshop

Musculoskeletal Lower Extremities Workshop
2017-2018
Working Group

Ani Gangopadhyaya, MD
Sasha Van Meter, MD
Nimmi Rajagopal, MD
Asra Khan, MD
Philip Bertulfo
Brian Runo
Distance Education, DME
UIC College of Medicine
Video Production:
Developed by:
Learning Objectives
Review the basic anatomy of the hip, knee, and ankle joints
Review the Core musculoskeletal exam
Learn the Cluster maneuvers related to each of these joints in preparation for the M2 Working Group
The Knee Exam
The Hip Exam
Knee Anatomy
MCL & LCL Tears:
Applying Valgus & Varus Stress
ACL & PCL Tears
Anterior & Posterior Drawer Tests
Valgus Stress
Varus Stress
The Knee Exam
The Basic Knee Exam
Inspection & Palpation
Inspection, Palpation, Range of Motion
Anterior Drawer Test
Posterior Drawer Test
Range of Motion
The maneuvers you'll need to be able to do for the M2 workshop
Anatomy of the Hip
Assessing Gait
Inspection & Palpation
Range of Motion
Stance: When the foot is on the ground and bears weight

Swing: When the foot moves forward and does not bear weight

The width of the base should be 2-4 inches from heel to heel

Anterior Landmarks
Posterior Landmarks
Measuring Leg Length
A wide-based gait suggests cerebellar disease or foot problems

Hip dislocation, arthritis or abductor weakness can cause the pelvis to drop on the opposite side, producing a waddling gait
Trochanteric bursa
Rotation
With the patient in the supine position, flex the leg to 90 degrees at both the hip and knee

Stabilize the pelvis by pressing down on the opposite anterior superior iliac spine of the hip to be tested

Grasp the ankle on the same side as the tested hip and swing the lower leg: medially for external rotation and laterally for internal rotation

Flexion
With the patient supine, place a hand under the patient's lumbar spine

Ask the patient to bend each knee up to the chest and pull it firmly against the abdomen
Extension
With the patient lying face down, extend the thigh in a posterior direction
ABduction
Stabilize the pelvis by pressing down on the opposite anterior superior iliac spine of the hip to be tested

Grasp the ankle on the same side and abduct the extended leg until you feel the iliac spine move

This movement marks the limit of hip abduction

ADduction
Stabilize the pelvis by pressing down on the opposite anterior superior iliac spine of the hip to be tested

Grasp the ankle on the same side and adduct the extended leg over the opposite extremity
In flexion deformity, as the opposite hip is flexed, the affected hip does not allow full leg extension and the affected thigh appears flexed
Restricted abduction is common in osteoarthritis
The maneuvers you'll need to be able to do for the M2 workshop
In Preparation for Working Group
See you on **XX** at 1:30 in your working groups!
Recommended Bates reading:
Hip 617-624
Knee 625-627
Patterns of pain, pages 644-650

View this Prezi: ~1hour
Complete the online quiz between **Insert Dates**

Be ready to practice the following maneuvers:
All MSK items from Core exam
Checklist items for Hip, Knee, Ankle as posted in this Prezi and on Blackboard

Wear loose/comfortable clothing as exams will be done on peers
Be ready to remove socks & shoes for ankle/foot exam
Have a yoga mat? Bring it to the session!

Remember to bring your laptop for the session!

To allow for more practice space, certain working groups will be moved to rooms 220, 427, and 529. Check Blackboard for your room assignment!
For this session, we will have colleagues from Physical Therapy join us!
Meniscal Tears
Thessaly test
The Ankle Exam
Foot and Ankle Anatomy
The maneuvers you'll need to be able to do for the M2 workshop
The Ankle Exam
Inspection, palpation, range of motion
Ankle Laxity tests
The Ottowa Knee & Ankle Rules
ie: Does my patient need an Xray?
Assessing for a labral tear
History, inspection & palpation
Special Maneuvers
Additional maneuvers to help understand etiology of hip pain
The Basics
Special maneuvers
The Basics
Assessing the ligaments
Assessing the menisci
The Basics
Advanced
Full transcript