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Decoding the Varus Valgus Test: A Comprehensive Guide for Understanding Knee Stability
Are you a coach, athlete, physical therapist, or simply someone curious about knee health? Understanding knee stability is crucial for preventing injuries and maintaining optimal performance. One key assessment tool used to evaluate this stability is the varus-valgus stress test. This comprehensive guide will delve deep into the varus valgus test, explaining its purpose, proper execution, interpretation, and limitations. We'll explore different variations, common misinterpretations, and provide you with the knowledge to effectively utilize this valuable diagnostic tool.
What is the Varus Valgus Stress Test?
The varus-valgus stress test is a clinical examination used to assess the stability of the medial and lateral collateral ligaments (MCL and LCL) of the knee joint. These ligaments are crucial for providing stability against inward (valgus) and outward (varus) forces. The test involves applying stress to the knee in different directions to evaluate the integrity of these ligaments. A positive test suggests potential ligamentous injury or instability.
Understanding Varus and Valgus Deformities:
Before we dive into the test itself, it's essential to understand the terms "varus" and "valgus."
Varus: A varus deformity refers to a bowing of the joint inward, like a bowlegged appearance. In the knee, a varus deformity means the knee bends inward towards the midline of the body.
Valgus: A valgus deformity is the opposite – a bowing outward of the joint, resembling knock-knees. In the knee, a valgus deformity indicates that the knee bends outward, away from the midline of the body.
Performing the Varus Valgus Stress Test: A Step-by-Step Guide
The test is typically performed with the patient in a supine position (lying on their back). Here's a detailed breakdown:
1. Patient Positioning: The patient lies supine on an examination table with their knees extended.
2. Stabilization: The examiner stabilizes the patient's thigh by placing one hand just above the knee joint on the thigh.
3. Varus Stress: The examiner applies a varus stress to the knee by placing their other hand on the lateral aspect (outside) of the knee and gently applying a force directed inwards towards the midline of the body. The examiner should pay attention to any laxity or opening of the joint line. This assesses the LCL.
4. Valgus Stress: The examiner then repeats the process, this time applying a valgus stress. The examiner places their hand on the medial aspect (inside) of the knee and gently applies a force directed outwards, away from the midline of the body. This assesses the MCL.
5. Comparison: The examiner compares the amount of movement (laxity) in the affected knee to the unaffected knee. Any significant difference in laxity or pain indicates a potential injury.
6. Different Knee Positions: The test can be performed with the knee in various positions (0°, 20°, and 30° of flexion) to further assess the stability at different ranges of motion. Flexion can sometimes help highlight more subtle ligamentous laxity.
Interpreting the Results:
A positive varus valgus stress test doesn't automatically confirm a ligament tear; instead, it suggests a potential issue requiring further investigation. A positive test is typically indicated by:
Increased Laxity: Noticeable increased joint opening compared to the unaffected side.
Pain: Significant pain during the application of stress.
End-Feel: The quality of resistance felt at the end of the range of motion. An abnormal soft or mushy end-feel could indicate a ligament injury.
Limitations of the Varus Valgus Stress Test:
While a valuable tool, the varus valgus stress test has limitations:
Subjectivity: The test relies on the examiner's interpretation of the amount of laxity and the patient's response to pain.
Inaccurate in certain cases: It may not accurately identify subtle ligament injuries or injuries involving other structures.
Requires experience: Accurate interpretation requires experience and a good understanding of knee anatomy and biomechanics.
Common Misinterpretations and Pitfalls:
Over-Interpretation: A small amount of laxity doesn’t automatically mean a significant injury. Comparison to the unaffected side is key.
Ignoring other factors: Pain can originate from various sources; isolating the cause requires careful consideration of other potential contributing factors.
Insufficient examination: The varus-valgus test is just one part of a thorough knee examination.
Alternative Tests for Knee Stability:
Other tests can be used in conjunction with the varus-valgus test to provide a more comprehensive assessment of knee stability, including Lachman's test, anterior drawer test, posterior drawer test, and pivot shift test.
Article Outline: A Deep Dive into Knee Stability Assessment
Introduction: Defining the varus valgus stress test and its importance.
Chapter 1: Anatomy and Biomechanics of the Knee: Detailed explanation of the knee joint, ligaments, and their functions.
Chapter 2: Performing the Test: Step-by-step guide with images/videos.
Chapter 3: Interpreting Results and Differential Diagnosis: Differentiating between various knee injuries and considering other contributing factors.
Chapter 4: Limitations and Alternative Tests: Exploring the limitations of the test and presenting alternative assessment techniques.
Chapter 5: Rehabilitation and Recovery: Strategies for rehabilitation and recovery following knee ligament injuries.
Conclusion: Summary of key takeaways and emphasizing the importance of comprehensive assessment.
(Note: The following sections would expand on each chapter of the outline above. Due to word count limitations, I'll provide concise summaries instead of full expansions.)
Chapter 1: Anatomy and Biomechanics of the Knee (This chapter would include detailed anatomical illustrations and descriptions of the knee joint structures, including the femur, tibia, fibula, patella, menisci, articular cartilage, MCL, LCL, ACL, PCL, and their roles in stability.)
Chapter 2: Performing the Test (This section would provide a detailed, step-by-step guide, ideally with images or videos demonstrating the correct technique for performing both the varus and valgus stress tests at different knee flexion angles. It would also highlight proper patient positioning and examiner hand placement to ensure accuracy.)
Chapter 3: Interpreting Results and Differential Diagnosis (This chapter would detail how to interpret the results of the test, differentiating between normal and abnormal findings. It would delve into possible differential diagnoses, including MCL sprain, LCL sprain, meniscus tear, and other potential sources of knee pain. The importance of considering patient history and other clinical findings would be emphasized.)
Chapter 4: Limitations and Alternative Tests (This chapter would fully discuss the limitations of the varus valgus stress test and present alternative tests for assessing knee stability, including the Lachman test, anterior drawer test, posterior drawer test, and pivot shift test. Each test would be described in detail, including its purpose, technique, and interpretation.)
Chapter 5: Rehabilitation and Recovery (This chapter would cover various rehabilitation and recovery strategies for knee ligament injuries, including RICE protocol (rest, ice, compression, elevation), physical therapy, bracing, and surgical interventions where necessary. The focus would be on evidence-based approaches and individualized treatment plans.)
Conclusion: The varus-valgus stress test is a valuable tool in assessing knee stability, but it's vital to interpret it within the context of a complete clinical examination. A thorough understanding of the test's limitations and the incorporation of other diagnostic tests ensure a comprehensive assessment and appropriate management of knee injuries.
FAQs:
1. Can I perform the varus valgus test on myself? No, it's crucial to have a qualified healthcare professional perform this test to avoid misinterpretation and potential harm.
2. Is a positive varus valgus test always indicative of a ligament tear? No, a positive test suggests possible ligamentous injury but requires further evaluation to confirm a diagnosis.
3. What are the potential consequences of ignoring a positive varus valgus test? Ignoring a positive test could lead to delayed treatment, chronic instability, further injury, and potentially long-term disability.
4. How long does it take to recover from a knee ligament injury? Recovery time depends on the severity of the injury and the individual's response to treatment, ranging from weeks to months.
5. What are the symptoms of a knee ligament injury? Common symptoms include pain, swelling, instability, clicking, and limited range of motion.
6. What imaging studies are typically used to diagnose knee ligament injuries? MRI scans are most commonly used to visualize ligamentous structures and assess the extent of any injury.
7. What are the different grades of ligament sprains? Ligament sprains are classified into grades I, II, and III, ranging from mild stretching to complete tear.
8. Can physiotherapy help with knee ligament injuries? Yes, physiotherapy plays a crucial role in rehabilitation, improving strength, range of motion, and stability.
9. When is surgery necessary for a knee ligament injury? Surgery may be required for severe ligament tears or when conservative treatment fails to provide adequate stability.
Related Articles:
1. Anterior Cruciate Ligament (ACL) Tears: Discusses the anatomy, mechanism of injury, diagnosis, and treatment of ACL tears.
2. Posterior Cruciate Ligament (PCL) Tears: Explains the anatomy, mechanism of injury, diagnosis, and treatment of PCL tears.
3. Medial Collateral Ligament (MCL) Sprains: Details the anatomy, mechanism of injury, diagnosis, and treatment of MCL sprains.
4. Lateral Collateral Ligament (LCL) Sprains: Describes the anatomy, mechanism of injury, diagnosis, and treatment of LCL sprains.
5. Meniscus Tears: Explains the anatomy, mechanism of injury, diagnosis, and treatment of meniscus tears.
6. Knee Osteoarthritis: Discusses the causes, symptoms, diagnosis, and management of osteoarthritis of the knee.
7. Knee Bursitis: Explains the causes, symptoms, diagnosis, and treatment of knee bursitis.
8. Patellofemoral Pain Syndrome: Discusses the causes, symptoms, diagnosis, and management of patellofemoral pain syndrome.
9. Knee Arthroscopy: Explains the procedure, indications, and recovery process for knee arthroscopy.
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| varus valgus test: Basic Orthopedic Exams Zachary Child, 2007 This pocket handbook for third- and fourth-year medical students and non-orthopedic clinicians is a quick, problem-focused tool for evaluating patients with musculoskeletal disorders. It teaches students basic orthopedic exam skills needed for many clinical rotations, and guides primary care and emergency/urgent care practitioners in initial evaluation of musculoskeletal problems. The consistent chapter format includes exam basics, orthopedic pearls, range of motion, specific muscles and their evaluation, and illustrated techniques for specific exams. A Quick Look feature briefly summarizes pertinent tests for each anatomical area. The book includes 120 drawings by the author, 39 x-rays, and numerous references for further information. |
| varus valgus test: An Osteopathic Approach to Diagnosis and Treatment Eileen L. DiGiovanna, Stanley Schiowitz, Dennis J. Dowling, 2005 Osteopathic medical students and faculty benefit from a uniquely practical text that organizes osteopathic concepts and step-by-step techniques into a single comprehensive volume. This new edition includes new, all-important updates on somatic and visceral problems, writing the osteopathic manipulative prescription, and case histories to reflect changes in the national licensing examination. The book’s integrated method for diagnosis and treatment embraces basic osteopathic history and philosophy, osteopathic palpation and manipulation, and specific manipulative treatments and concepts. Abundant photographs demonstrate step-by-step techniques. Meticulous illustrations depict underlying anatomy. |
| varus valgus test: Postgraduate Orthopaedics Paul A. Banaszkiewicz, Deiary F. Kader, 2012-08-16 The must-have book for candidates preparing for the oral component of the FRCS (Tr and Orth). |
| varus valgus test: Fundamentals of Sports Injury Management Marcia K. Anderson, 2003 Completely revised Second Edition provides a foundation for the prevention, recognition, assessment, management, disposition, and rehabilitation of sports-related injuries and illnesses as it integrates basic medical concepts with relevant scientific information. This book speaks to students in coaching, exercise science, recreation and teacher education, for learning what to do as the first on-site respondent to a sports-related injury. Guidelines are provided to help identify common conditions initially cared-for on-site, and when to know to refer an individual to advanced care. The text contains major revisions and includes illustrations and additional tables. Connection Website: connection.LWW.com/go/andfund. |
| varus valgus test: Functional Soft Tissue Examination and Treatment by Manual Methods Warren I. Hammer, 2005 This second edition of this very successful book includes chapters written by experts in the methods of manual treatment and provides step-by-step instructions on how to examine your patient using a logical sequence of passive, contractile, and special tests, and how to relate findings to biomechanical problems and lesions. Included are hundreds of diagrams, photographs, illustrations, and summary charts. In this second edition, chapters from the first edition have been thoroughly revised and updated and new material has been added on Myofascial Release, Somatics, Post-Facilitation Stretch, Friction Massage, Hypo- and Hyperpronation of the Foot, Strain and Counter Strain, Gait, the Extremities, and the Spine. |
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| varus valgus test: Rotatory Knee Instability Volker Musahl, Jón Karlsson, Ryosuke Kuroda, Stefano Zaffagnini, 2016-09-27 This book is designed to equip the reader with the knowledge and tools required for provision of individualized ACL treatment based on the best available evidence. All major aspects of the assessment of rotatory knee instability are addressed in depth. A historical overview of arthrometers, both invasive and non-invasive, is provided, and newly developed devices for the measurement of rotatory knee laxity are considered. Recent advances with respect to the pivot shift test are explained and evidence offered to support a standardized pivot shift test and non-invasive quantification of the pivot shift. Specific surgical techniques for rotatory laxity are described, with presentation of the experience from several world-renowned centers. In addition, functional rehabilitation and “return to play” are discussed. In keeping with the emphasis on an individualized approach, the book highlights individualization of surgical reconstruction techniques in accordance with the specific injury pattern and grade of rotatory knee laxity as well as the use of individualized rehabilitation techniques. Numerous high-quality images illustrate key points and clear take-home messages are provided. |
| varus valgus test: Orthopedic Physical Assessment David J. Magee, BPT, PhD, CM, 2013-12-04 Newly updated, this full-color text offers a rich array of features to help you develop your musculoskeletal assessment skills. Orthopedic Physical Assessment, 6th Edition provides rationales for various aspects of assessment and covers every joint of the body, as well as specific topics including principles of assessment, gait, posture, the head and face, the amputee, primary care, and emergency sports assessment. Artwork and photos with detailed descriptions of assessments clearly demonstrate assessment methods, tests, and causes of pathology. The text also comes with an array of online learning tools, including video clips demonstrating assessment tests, assessment forms, and more. Thorough, evidence-based review of orthopedic physical assessment covers everything from basic science through clinical applications and special tests. 2,400 illustrations include full-color clinical photographs and drawings as well as radiographs, depicting key concepts along with assessment techniques and special tests. The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site The latest research and most current practices keep you up to date on accepted practices. Evidence-based reliability and validity tables for tests and techniques on the EVOLVE site provide information on the diagnostic strength of each test and help you in selecting proven assessment tests. A Summary (Précis) of Assessment at the end of each chapter serves as a quick review of assessment steps for the structure or joint being assessed. Quick-reference data includes hundreds of at-a-glance summary boxes, red-flag and yellow-flag boxes, differential diagnosis tables, muscle and nerve tables, and classification, normal values, and grading tables. Case studies use real-world scenarios to help you develop assessment and diagnostic skills. Combined with other books in the Musculoskeletal Rehabilitation series - Pathology and Intervention, Scientific Foundations and Principles of Practice, and Athletic and Sport Issues - this book provides the clinician with the knowledge and background necessary to assess and treat musculoskeletal conditions. NEW! Online resources include video clips, assessment forms, text references with links to MEDLINE® abstracts, and more. NEW! Video clips demonstrate selected movements and the performance of tests used in musculoskeletal assessment. NEW! Text references linked to MEDLINE abstracts provide easy access to abstracts of journal articles for further review. NEW! Forms from the text with printable patient assessment forms can be downloaded for ease of use. NEW! Updated information in all chapters includes new photos, line drawings, boxes, and tables. NEW! The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site. |
| varus valgus test: Total Knee Arthroplasty James Alan Rand, 1993 This comprehensive reference on total knee arthroplasty describes all surgical techniques and prosthetic designs for primary and revision arthroplasty, discusses every aspect of patient selection, preoperative planning, and intraoperative and postoperative care. |
| varus valgus test: Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines Shirley Sahrmann, 2010-12-15 Extensively illustrated and evidence based, Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines helps you effectively diagnose and manage musculoskeletal pain. It discusses diagnostic categories and their associated muscle and movement imbalances, and makes recommendations for treatment. Also covered is the examination itself, plus exercise principles, specific corrective exercises, and the modification of functional activities. Case studies provide examples of clinical reasoning, and a companion Evolve website includes video clips of tests and procedures. Written and edited by the leading experts on muscle and movement, Shirley Sahrmann and associates, this book is a companion to the popular Diagnosis and Treatment of Movement Impairment Syndromes. - An organized and structured method helps you make sound decisions in analyzing the mechanical cause of movement impairment syndromes, determining the contributing factors, and planning a strategy for management. - Detailed, yet clear explanations of examination, exercise principles, specific corrective exercises, and modification of functional activities for case management provide the tools you need to identify movement imbalances, establish the relevant diagnosis, and develop the corrective exercise prescription. - Case studies illustrate the clinical reasoning used in managing musculoskeletal pain. - Evidence-based research supports the procedures covered in the text. - Over 360 full-color illustrations -- plus tables and summary boxes -- highlight essential concepts and procedures. - A companion Evolve website includes video clips demonstrating the tests and procedures and printable grids from the book. |
| varus valgus test: Clinical Assessment and Examination in Orthopedics C Rex, 2012-03-31 This second edition is a concise guide to clinical assessment and examination in orthopaedics. Beginning with an introduction to history taking and clinical examination, the following chapters discusses the examination of different parts of the body. Each chapter discusses clinical diagnostic tests relevant to the specific region, as well as common conditions, symptoms and signs. With almost 250 illustrations on demonstration techniques and clinical pictures with diagnosis and examination techniques, this new edition sets out the sequence of examination in a more practical, step by step way than the previous edition. |
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| varus valgus test: Musculoskeletal Sports and Spine Disorders Stuart B. Kahn, Rachel Yinfei Xu, 2018-02-08 Fulfilling the need for an easy-to-use resource on managing musculoskeletal disorders and sports injuries, this book provides differential diagnostic workups with recommended gold standard evaluations that lead to a simple and accurate diagnosis, followed by first-line treatment options. Organized by five sections - head and neck, upper extremity, lower extremity, abdomen/pelvis with trunk and chest, and cervical, thoracic and lumbosacral spine - chapters present a concise summary and move on to a description of the most common symptoms, etiology, epidemiology and/or common causes if traumatic in nature. The best and most accepted diagnostic tests are illustrated, along with recommended evidence-based medicine and what may be done based on community standards of care. Treatment options will be listed in order of the most conservative to the most aggressive. This complete reference will provide primary care, physiatry, and ER physicians, residents, PA’s and students a simple and practical approach for clinical and academic use. |
| varus valgus test: The Sports Medicine Resource Manual Peter H. Seidenberg, Anthony I. Beutler, 2008 Written by primary care sports medicine physicians, The Sports Medicine Resource Manual is the one musculoskeletal textbook that is ideally suited for family medicine and sports medicine providers. Chapters on physical exam and diagnosis are carefully integrated with sections on rehabilitation and management-including a complete guide to procedural skills such as casting, injections, compartment testing, running shoe prescriptions and more. In this conveniently sized volume, sports medicine physicians, orthopedists, emergency medicine physicians, physical therapists, pediatricians, team physicians, athletic trainers, and others share their expertise on everything from diagnosis and proper rehabilitation of musculoskeletal pain to field side coverage and acute management of the injured athlete. Designed as both a tutorial and a trusted reference, this easy-to-reference resource will provide you with expert guidance for years to come. Integrates sports medicine diagnosis and management with procedural skills, making this a one-stop reference for outpatient sports and musculoskeletal medicine. Features expert guidance from multiple medical disciplines, providing you with well-rounded coverage from various perspectives. Includes evidence-based guidelines and ratings, wherever available, ensuring you have the best clinical knowledge to deliver the best possible outcomes. Emphasizes rehabilitation of soft tissue injury, fracture management, and musculoskeletal procedures to help you effectively treat more of what you see regularly. Presents appendices on exercise and injury for special populations, including pregnant women and pediatric and geriatric patients, enabling you to appropriately care for the diverse range of individuals in primary care practice. Uses a templated format throughout making reference a snap. |
| varus valgus test: Netter's Orthopaedic Clinical Examination Joshua Cleland, Shane Koppenhaver, Jonathan Su, 2015-11-02 With its unique combination of classic Netter artwork, exam photos and videos, and rigorous evidence-based approach, Netter's Orthopaedic Clinical Examination, 3rd Edition, helps you get the most clinically significant information from every orthopaedic examination. This new edition, by Drs. Joshua Cleland, Shane Koppenhaver, and Jonathan Su, allows you to quickly review the reliability and diagnostic utility of musculoskeletal physical exams and make it easier to incorporate evidence into your clinical decision making. - Extremely user-friendly and well organized, this unique text walks you through the anatomy and clinical exam, then critically reviews all literature for given diagnostic tests. - A tabular format provides quick access to test reliability and diagnostic utility, study quality, anatomy and biomechanics, and summary recommendations for applying evidence in practice. - Quality ratings for 269 studies, investigating a test's reliability using the 11-item Quality Appraisal of Diagnostic Reliability Checklist. - Evidence-based approach helps you focus on the effectiveness of the clinical tests available and review recent studies quickly to determine which test will best predict a specific diagnosis. - 84 new studies, 34 new photos and 25 new videos on Student Consult. - QAREL (Quality Appraisal for Reliability Studies) checklists included for each reliability study. - A downloadable Student Consult eBook is included with this printed book. |
| varus valgus test: Handbook of Upper Extremity Examination Roger Pillemer, 2021-11-20 In addition to complementary radiographic imaging, the physical exam is an essential diagnostic element for the orthopedic surgeon. As such, learning to perform this exam thoroughly is of utmost importance to medical students, residents and interns on an orthopedic rotation and in later practice. This practical text succinctly presents all of the necessary information regarding the physical examination of the upper extremity. The hand, wrist, elbow and shoulder are discussed in dedicated thematic sections, with each section comprised of three main chapters. The initial chapter describes the musculoskeletal anatomy and function of the joint, presenting the tests themselves along with the rationale for performing them. The second chapter presents the systematic examinations carried out in every case, and the third chapter describes examinations for specific conditions relating to the joint, including tendinopathies, osteoarthritis, neurological conditions, deformities, and more. Plentiful bullet points and color images throughout the text describe and illustrate each test and physical sign. Convenient and user-friendly, Handbook of Upper Extremity Examination is a valuable, portable guide to this all-important diagnostic tool for students and practitioners alike. |
| varus valgus test: Orthopedic Physical Assessment David J. Magee, 2008-01-01 Newly updated, this full-color text offers a rich array of features to help you develop your musculoskeletal assessment skills. Orthopedic Physical Assessment, 6th Edition provides rationales for various aspects of assessment and covers every joint of the body, as well as specific topics including principles of assessment, gait, posture, the head and face, the amputee, primary care, and emergency sports assessment. Artwork and photos with detailed descriptions of assessments clearly demonstrate assessment methods, tests, and causes of pathology. The text also comes with an array of online learning tools, including video clips demonstrating assessment tests, assessment forms, and more. Thorough, evidence-based review of orthopedic physical assessment covers everything from basic science through clinical applications and special tests. 2,400 illustrations include full-color clinical photographs and drawings as well as radiographs, depicting key concepts along with assessment techniques and special tests. The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site The latest research and most current practices keep you up to date on accepted practices. Evidence-based reliability and validity tables for tests and techniques on the EVOLVE site provide information on the diagnostic strength of each test and help you in selecting proven assessment tests. A Summary (Précis) of Assessment at the end of each chapter serves as a quick review of assessment steps for the structure or joint being assessed. Quick-reference data includes hundreds of at-a-glance summary boxes, red-flag and yellow-flag boxes, differential diagnosis tables, muscle and nerve tables, and classification, normal values, and grading tables. Case studies use real-world scenarios to help you develop assessment and diagnostic skills. Combined with other books in the Musculoskeletal Rehabilitation series - Pathology and Intervention, Scientific Foundations and Principles of Practice, and Athletic and Sport Issues - this book provides the clinician with the knowledge and background necessary to assess and treat musculoskeletal conditions. NEW! Online resources include video clips, assessment forms, text references with links to MEDLINE® abstracts, and more. NEW! Video clips demonstrate selected movements and the performance of tests used in musculoskeletal assessment. NEW! Text references linked to MEDLINE abstracts provide easy access to abstracts of journal articles for further review. NEW! Forms from the text with printable patient assessment forms can be downloaded for ease of use. NEW! Updated information in all chapters includes new photos, line drawings, boxes, and tables. NEW! The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site. |
| varus valgus test: Diagnostic Evaluation of the Knee Michael Strobel, Hans-Werner Stedtfeld, 2012-12-06 Knee surgeons world wide have been aware that a beautifully illustrated book on diagnostic evaluation of the knee existed. What we in the English speaking world did not appreciate was the superb quality of the text that ac companied these splendid illustrations. Now, Dr. Michael Strobel and Dr. Hans-Werner Stedtfeld's work, Diagnostic Evaluation of the Knee, has been translated by Mr. Terry Telger into an English text that is clear and cogent. The authors' message is comprehensive and straight forward. They show how diagnosis of knee disorders lends itself to a disciplined, orderly thought pro cess based on a substantial body of scientific knowledge. This book, through effective illustrations, clarity of text and thought, and subject organization, leads the reader through the diagnostic evaluation of the knee in an enjoy able and unforgettable way. Some may think the diagnostic process is dead with the advent of magnetic resonance imaging. They are wrong: the diagnostic process has never been more alive, and M. Strobel and H.-W. Stedtfeld capture the excitement of modern day diagnosis through the integration of many disciplines - anato my, pathophysiology, general examination, special examinations, and special studies. This is the unique character of this book and why it will be a text ap preciated by all who care for the knee-injured patient. |
| varus valgus test: Orthopedic Physical Assessment - E-Book David J. Magee, 2013-12-01 Newly updated, this full-color text offers a rich array of features to help you develop your musculoskeletal assessment skills. Orthopedic Physical Assessment, 6th Edition provides rationales for various aspects of assessment and covers every joint of the body, as well as specific topics including principles of assessment, gait, posture, the head and face, the amputee, primary care, and emergency sports assessment. Artwork and photos with detailed descriptions of assessments clearly demonstrate assessment methods, tests, and causes of pathology. The text also comes with an array of online learning tools, including video clips demonstrating assessment tests, assessment forms, and more. Thorough, evidence-based review of orthopedic physical assessment covers everything from basic science through clinical applications and special tests. 2,400 illustrations include full-color clinical photographs and drawings as well as radiographs, depicting key concepts along with assessment techniques and special tests. The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site The latest research and most current practices keep you up to date on accepted practices. Evidence-based reliability and validity tables for tests and techniques on the EVOLVE site provide information on the diagnostic strength of each test and help you in selecting proven assessment tests. A Summary (Précis) of Assessment at the end of each chapter serves as a quick review of assessment steps for the structure or joint being assessed. Quick-reference data includes hundreds of at-a-glance summary boxes, red-flag and yellow-flag boxes, differential diagnosis tables, muscle and nerve tables, and classification, normal values, and grading tables. Case studies use real-world scenarios to help you develop assessment and diagnostic skills. Combined with other books in the Musculoskeletal Rehabilitation series — Pathology and Intervention, Scientific Foundations and Principles of Practice, and Athletic and Sport Issues — this book provides the clinician with the knowledge and background necessary to assess and treat musculoskeletal conditions. NEW! Online resources include video clips, assessment forms, text references with links to MEDLINE® abstracts, and more. NEW! Video clips demonstrate selected movements and the performance of tests used in musculoskeletal assessment. NEW! Text references linked to MEDLINE abstracts provide easy access to abstracts of journal articles for further review. NEW! Forms from the text with printable patient assessment forms can be downloaded for ease of use. NEW! Updated information in all chapters includes new photos, line drawings, boxes, and tables. NEW! The use of icons to show the clinical utility of special tests supplemented by evidence - based reliability & validity tables for tests & techniques on the Evolve site. |
| varus valgus test: Revision ACL Reconstruction Robert G. Marx, 2013-09-05 Although anterior cruciate ligament (ACL) reconstruction has a high success rate, a substantial number of patients are left with unsatisfactory results. Revision ACL Reconstruction: Indications and Technique provides detailed strategies for planning and executing revision ACL reconstructions. Concise chapters by a leading group of international orthopedic surgeons cover the diagnosis of failed ACL reconstruction, patient evaluation, preoperative planning for revision ACL surgery and complex technical considerations. |
| varus valgus test: The Art of the Musculoskeletal Physical Exam John G. Lane, Alberto Gobbi, João Espregueira-Mendes, Camila Cohen Kaleka, Nobuo Adachi, 2023-06-16 This book is an invaluable resource for all those seeking to enhance their proficiency in physical examination. Emphasizing its importance for thorough assessments and accurate diagnoses, it equips practitioners with comprehensive theoretical and practical knowledge. With seven sections devoted to different orthopedic structures, the book meticulously examines their underlying anatomy, pathological conditions, and diagnostic methodologies. Each author presents joint-specific tests, and detailed anatomical insights, enabling accurate assessments and identification of underlying conditions. Written and edited by members of ISAKOS, this collaboration draws upon the expertise of leading international experts. Appealing to a broad readership, it is an invaluable tool for orthopedists, sports medicine physicians, physical therapists, athletic trainers and students. |
| varus valgus test: Orthopedic & Athletic Injury Examination Handbook Chad Starkey, Sara D. Brown, 2015-04-16 Stands on its own as an easy-to-carry reference in the clinic. [Its] strengths… are its clear diagrams and the table format frequently used to present information. Athletic trainers and physical therapists will find this on-the-field or in-the-clinic handbook a useful reference with clear explanations and diagrams.—Advance for Physical Therapists and PT Assistants, review of a previous edition. Tap into easy-to-follow, step-by-step guidance on the evaluation and initial management of specific orthopedic and athletic injuries with the companion to Examination of Orthopedic and Athletic Injuries, 4th Edition. From evaluative procedures for palpation and range of motion through neurologic, ligamentous, and special tests, everything you need now in the lab, and later in the field or in the clinic, is here. It’s a terrific preparation tool for the BOC examination, too. |
| varus valgus test: Examination of Musculoskeletal Injuries Sandra J. Shultz, Peggy A. Houglum, David H. Perrin, 2015-11-10 Examination of Musculoskeletal Injuries, Fourth Edition With Web Resource, guides current and future athletic trainers and rehabilitation professionals through the examination and evaluation of musculoskeletal injuries both on and off the field. The text presents injury examination strategies in on-site, acute, and clinical settings and provides the information on mastering the skills needed for the Board of Certification examination for athletic trainers as determined by the sixth edition of Athletic Training Role Delineation Study/Practice Analysis for entry-level athletic trainers. This updated fourth edition contains foundational information on a wide spectrum of injuries and the appropriate tests for examining and diagnosing them. Readers will learn to obtain an accurate injury history from the patient, inspect the injury and related areas, test motion control, palpate both bone and soft tissues, and examine function in order to gauge the player’s readiness to return to play. The fourth edition also includes the following enhancements: • A new online video library contains more than 51 short video clips that correspond to and demonstrate evaluation techniques for various musculoskeletal disorders found throughout the text. • Full-color photos and medical artwork have been added throughout the text to clarify testing techniques and enhance knowledge of relevant body structures. • Substantial updates provide the most recent evidence-based clinical information. • An expanded selection of special tests and injury-specific examinations are now presented in a more accessible format and include a photo or video, description of the purpose, patient and clinician positions for the test, procedures performed, and possible outcomes. The content of Examination of Musculoskeletal Injuries, Fourth Edition With Web Resource, has been restructured and focused to provide applicable information in a straightforward manner. Part I is aimed at entry-level students and presents general and introductory skills for each component of injury examination, including basic terminology and a breakdown of the examination procedure. Each component is then explored in depth along with general purposes and techniques. Part I ends by incorporating the various components into a systematic strategy for examination based on severity of injury and environment. Part II then applies the principles learned in the previous chapters to the recognition and examination of injuries organized by specific regions of the body. Each chapter includes strategies for examination immediately after an injury as well as examinations seen later in a clinical setting. To assist student comprehension and knowledge retention, key terms are in boldface throughout the text and are defined in the glossary. Symbols throughout the text alert students to essential procedures and highlight important information. The web resource houses printable tables of special tests, examination checklists and forms that students can use in laboratory work and review sessions, and a robust video library. To aid instructors, the text includes a suite of ancillary materials featuring a test package, instructor guide, and presentation package plus image bank. Examination of Musculoskeletal Injuries, Fourth Edition With Web Resource, is an essential resource for students of athletic training and therapy as well as current practitioners in the field who wish to use evidence-based procedures in their clinical practice to ensure safe and accurate diagnoses of injuries. |
| varus valgus test: Posterior Cruciate Ligament Injuries Gregory C. Fanelli, MD, 2015-02-27 Now in a revised and expanded second edition including ten new chapters, this classic text on the diagnosis and management of posterior cruciate ligament injuries represents the state of the art. Comprehensive and used-friendly, the book covers PCL anatomy and biomechanics, diagnosis and evaluation, and both surgical and non-surgical treatment strategies. Surgical chapters discuss graft selection and open and arthroscopic techniques, including both primary and revision surgery and combined reconstruction with other knee ligaments. New chapters illustrate cutting-edge and advanced surgical techniques in reconstruction and primary repair, articular cartilage resurfacing and meniscus transplant in the PCL injured knee, mechanical graft tensioning, the role of osteotomy, treatment of PCL injuries in children, results of treatment and outcomes data in PCL injuries, clinical case studies, and the editor’s experience chapter based on 24 years of treating PCL injuries. Complications, bracing and rehabilitation round out the presentation. Written and edited by leaders in the management of injuries to the knee, this will be an invaluable text for orthopedic surgeons and sports medicine practitioners alike. |
| varus valgus test: Shoulder and Elbow Injuries in Athletes Robert A. Arciero, Frank A. Cordasco, Matthew T. Provencher, 2017-10-17 Thorough and concise, this practical reference provides a unique, on-field management approach to all athletic injuries to the shoulder and elbow, as well as nonoperative and operative treatment options, including arthroscopy and open surgery. Focusing on high-performance athletes, leading authorities in the field demonstrate how to provide pain relief, restore function, and return the athlete to sport and to prior level of performance in a safe and timely fashion. - Showcases the knowledge and expertise of an international group of editors and authors who have served as president of the American Orthopaedic Society for Sports Medicine, the American Shoulder and Elbow Surgeons and the Arthroscopy Association of North America, are physicians or consultants for professional and collegiate sports teams, have won awards for research in the field of shoulder surgery, are editors and reviewers for peer-reviewed journals, and much more. - Contains rehabilitation guidelines and critical return-to-sport protocols – essential information for nonsurgical healthcare providers -- primarily on athletes under the age of 40, with some consideration of the older athlete (professional golf, for example). - Contains a section in each chapter covering On-the-Field Management and Early Post-Injury Assessment and Treatment – a must-read for immediate care of the injured athlete and ensuring the safe return to play. - Covers the most recent advances in the management of tendon tears in elite and overhead athletes, including prevention in youth sports, early sports specialization, and changing standards of care regarding shoulder and elbow instability. - Provides a thorough review of current ulnar collateral ligament injury diagnosis, imaging, non-operative management, and surgery, as well as acromioclavicular and sternoclavicular joint injuries, clavicle and olecranon fractures, and OCD of the capitellum. |
| varus valgus test: Practical Orthopedic Examination Made Easy Manish Kumar Varshney, 2019-09-30 The new edition of this book is a practical guide to the clinical examination of orthopaedic complaints. Divided into 12 sections, the text begins with an overview of how to approach a physical examination. The following sections cover examination techniques for injuries in each part of the musculoskeletal system, from hip and knee, foot and ankle, to shoulder, elbow, wrist and hand; and spine. The book concludes with guidance on how to read an X-ray and provides a selection of short cases and long and short questions to help candidates prepare for theory examinations. Presented in question and answer format, the third edition has been fully revised and includes new topics to provide trainees with the latest advances in the field. The comprehensive text is further enhanced by clinical photographs, diagrams and tables to assist learning. Key points Practical guide to the clinical examination of orthopaedic injuries Fully revised, new edition providing trainees with latest advances in the field Provides short and long questions to help candidates prepare for theory examinations Previous edition (9789350257838) published in 2012 |
| varus valgus test: Musculoskeletal Diseases 2021-2024 Juerg Hodler, Rahel A. Kubik-Huch, Gustav K. von Schulthess, 2021 This open access book focuses on imaging of the musculoskeletal diseases. Over the last few years, there have been considerable advances in this area, driven by clinical as well as technological developments. The authors are all internationally renowned experts in their field. They are also excellent teachers, and provide didactically outstanding chapters. The book is disease-oriented and covers all relevant imaging modalities, with particular emphasis on magnetic resonance imaging. Important aspects of pediatric imaging are also included. IDKD books are completely re-written every four years. As a result, they offer a comprehensive review of the state of the art in imaging. The book is clearly structured with learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers easily navigate through the text. As an IDKD book, it is particularly valuable for general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic knowledge, and for clinicians interested in imaging as it relates to their specialty. |
| varus valgus test: The Adult Knee John J. Callaghan, 2003 Written and edited by the foremost experts in knee surgery, this definitive two-volume reference provides comprehensive coverage of the evaluation and surgical management of problems of the adult knee. In 117 detailed chapters, the text covers basic science, clinical science, soft tissue injury of the knee, tendon and ligament surgery, osteochondral injury to the knee, patella femoral disorders, alternatives to arthroplasty for knee arthritis, primary total knee arthroplasty, perioperative management in total knee replacement, complications of total knee replacement, revision total knee arthroplasty, and future developments. |
| varus valgus test: Examination of Orthopedic & Athletic Injuries Chad Starkey, Sara D Brown, 2015-02-06 Organized by body region, each chapter begins with a review of anatomy and biomechanics; proceeds through clinical evaluation, pathologies, and related special tests; and concludes with a discussion of on-field or initial management of specific injuries |
| varus valgus test: Musculoskeletal Examination of the Hip and Knee Anil Ranawat, Bryan Kelly, 2024-06-01 The physical examination of the hip and knee can be a complex topic for professionals with all levels of clinical experience. How can advance concepts be taught in a user-friendly, clear format, while still providing necessary information for effective diagnosis and treatment of the hip and knee? Musculoskeletal Examination of the Hip and Knee: Making the Complex Simple by Drs. Anil Ranawat and Bryan T. Kelly answers these questions. Written by experts, this easy-to-carry book provides a thorough review of the most common pathologic hip and knee conditions, techniques for diagnosis, as well as the appropriate treatment for each condition. Musculoskeletal Examination of the Hip and Knee: Making the Complex Simple contains clear photographic demonstrations, tables, and charts throughout its pages, allowing a thorough and concise examination of the hip and knee. A glance at some of what is covered inside: Physical Examination Basics and specific tests of the physical examination of the hip and knee General Imaging Basics of general imaging of the hip and knee Common Conditions Arthroscopic management of labral tears, snapping hip syndromes, meniscal tears, and more Musculoskeletal Examination of the Hip and Knee: Making the Complex Simple contains essential information to successfully take a complex subject and bring it to a level that will be welcomed by orthopedic residents, attendings, physical therapists, athletic trainers, medical students in training, and other health care providers. |
| varus valgus test: Skiing Trauma and Safety C. Daniel Mote, 1991 Twenty-one papers from the symposium held in Riksgrasen, Sweden, May 1989, present the latest in skiing injury prevention, addressing: the knee, skiing injury statistics, the ski boot, the ski, and education and behavior. Annotation copyright Book News, Inc. Portland, Or. |
| varus valgus test: Pathology and Intervention in Musculoskeletal Rehabilitation David J. Magee, James E. Zachazewski, William S. Quillen, 2008-01-01 Design and implement a rehab program on your own with Pathology and Intervention in Musculoskeletal Rehabilitation, 2nd Edition. Part of Magee's popular Musculoskeletal Rehabilitation Series, this pathology text for physical therapists provides clear guidance on patient management relative to specific musculoskeletal pathology, injury, and illness - all based on a sound understanding of basic science and principles of practice. It focuses on the specific pathologies most often seen in the clinic, and discusses the best methods for intervention for the different areas of the body in the context of the tissue-healing model. Each intervention features a rationale, along with the pathology and problem presented; stage of healing; evidence in the literature; and clinical reasoning considerations. Dedicated and focused information on the specific pathologies most often seen in the clinic, as well as the best methods for intervention for the different areas of the body, minimizes duplication of information by referring you to other titles in the Musculoskeletal Rehabilitation Series for basic scientific information regarding inflammation, healing, tissue deformation, and the development of muscular strength and endurance. Trusted experts in musculoskeletal rehabilitation, along with internationally recognized contributors, present the best evidence behind contemporary interventions directed toward the treatment of the impairments and functional limitations associated with acute, chronic, and congenital musculoskeletal conditions occurring across the lifespan. Evidence-based content, with over 4,000 references, supports the scientific principles for rehabilitation interventions, providing the best evidence for the management of musculoskeletal pathology and injury. NEW! The Skin and Wound Healing chapter looks at the numerous tools available to assist in objectively monitoring and treating a patient with an acute or chronic wound. NEW! Rotator Cuff Pathology chapter highlights the anatomy, function, and etiology of the rotary cuff, and addresses rotary cuff injuries, physical examination, and non-operative and operative treatment. UPDATED! Substantially revised chapter on the Thoracic Ring ApproachT facilitates clinical reasoning for the treatment of the thoracic spine and ribs through the assessment and treatment of thoracic spine disorders and how they relate to the whole kinetic chain. UPDATED! Revised Lumbar Spine - Treatment of Motor Control Disorders chapter explores some of the research evidence and clinical reasoning pertaining to instability of the lumbar spine so you can better organize your knowledge for immediate use in the clinical setting. UPDATED! Significantly revised chapter on the treatment of pelvic pain and dysfunction presents an overview of specific pathologies pertaining to the various systems of the pelvis - and highlights how The Integrated Systems Model for Disability and Pain facilitates evidence-based management of the often complex patient with pelvic pain and dysfunction. NEW! Musculoskeletal Bone and Soft Tissue Tumors chapter covers common bones tumors, anatomic considerations and rehabilitation, pediatric patients, and amputation related to cancer. UPDATED! Thoroughly revised chapters with additional references ensure you get the most recent evidence and information available. NEW! Full color design and illustration program reflects what you see in the physical world to help you recognize and understand concepts more quickly. |
| varus valgus test: Musculoskeletal Examination Jeffrey Gross, Joseph Fetto, Elaine Rosen, 2011-09-07 Musculoskeletal Examination is a user-friendly textbook designed for students, physical therapists and physicians. It is uniquely multidisciplinary in its approach, being written by a physiatrist, physical therapist and orthopedist. With tables and boxed features to emphasize and summarize key concepts, and 'sample examination' boxes to highlight and test difficult areas, it is ideal for teaching introductory courses yet detailed enough for professional reference within clinical practice. It includes an easy-to-follow examination process for all the joints and spine, as well as combining biomechanics with physical examination to enhance understanding of function. This third edition includes more and better anatomy illustrations; over 850 illustrations, x-rays and MRIs are perfect as a quick reference guide, while the detailed descriptions and clinically relevant examples of frequently encountered conditions will help out even the most novice practitioner. The chapter on basic science, the brief overview of anatomy, and the introductory remarks at the start of each chapter that provide a biomechanical overview of the region featured, all ensure Musculoskeletal Examination will help you gain the understanding necessary to make a correct diagnosis and determine a successful treatment plan for your patients. Musculoskeletal Examination is ideal for physiotherapists, physiatrists, orthopedists, medical students, practitioners and all those involved in sports medicine and clinical massage. |
| varus valgus test: Fundamentals of Orthopedics Mukul Mohindra, Jitesh Kumar Jain, 2017-12-31 This book is a complete guide to orthopaedics for undergraduate medical students helping them prepare for both theory and practical examinations. Beginning with an introduction to the field, the following sections cover the diagnosis and management of different disorders. The second edition has been fully revised to provide students with the latest information and includes a new chapter on sports injuries and rehabilitation. Each topic includes a summary of the key points and the book features a practice session of multiple choice questions and answers. The text is highly illustrated with more than 1300 clinical photographs, radiological images, diagrams and tables and concludes with a picture quiz to help students prepare for image-based examination questions. Key points Complete guide to orthopaedics for undergraduate medical students Fully revised, second edition featuring new chapter on sports injuries and rehabilitation Includes practice session of multiple choice questions and picture quiz Previous edition (9789351529576) published in 2016 |
| varus valgus test: Evidence-Based Physical Examination Kate Sustersic Gawlik, DNP, APRN-CNP, FAANP, Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, Alice M. Teall, DNP, APRN-CNP, FAANP, 2020-01-27 The first book to teach physical assessment techniques based on evidence and clinical relevance. Grounded in an empirical approach to history-taking and physical assessment techniques, this text for healthcare clinicians and students focuses on patient well-being and health promotion. It is based on an analysis of current evidence, up-to-date guidelines, and best-practice recommendations. It underscores the evidence, acceptability, and clinical relevance behind physical assessment techniques. Evidence-Based Physical Examination offers the unique perspective of teaching both a holistic and a scientific approach to assessment. Chapters are consistently structured for ease of use and include anatomy and physiology, key history questions and considerations, physical examination, laboratory considerations, imaging considerations, evidence-based practice recommendations, and differential diagnoses related to normal and abnormal findings. Case studies, clinical pearls, and key takeaways aid retention, while abundant illustrations, photographic images, and videos demonstrate history-taking and assessment techniques. Instructor resources include PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank. This is the physical assessment text of the future. Key Features: Delivers the evidence, acceptability, and clinical relevance behind history-taking and assessment techniques Eschews “traditional” techniques that do not demonstrate evidence-based reliability Focuses on the most current clinical guidelines and recommendations from resources such as the U.S. Preventive Services Task Force Focuses on the use of modern technology for assessment Aids retention through case studies, clinical pearls, and key takeaways Demonstrates techniques with abundant illustrations, photographic images, and videos Includes robust instructor resources: PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank Purchase includes digital access for use on most mobile devices or computers |
| varus valgus test: Hospital for Special Surgery Orthopaedics Manual Thomas P. Sculco, Moe R. Lim, Andrew D. Pearle, Anil S. Ranawat, 2012-12-22 This book has nine chapters of accurate, relevant, and, most important, high-yield orthopaedic facts, organized by the subspecialties--Provided by publisher. |
| varus valgus test: Surgery and Arthroscopy of the Knee Werner Müller, Werner Hackenbruch, 2012-12-06 The need for greater international collaboration is becoming increas. ingly clear. Practically every nation or people has, in addition to its own characteristics and history, its own medical tradition. Methods and ways of thinking that are successfully established in one place may not be accepted in another for some time. The medical tradition and training in different countries can take quite different forms. What would our present knowledge be - Without the creative, spontaneous ideas and contributions from the romance countries? - Without the opportunity of research, as it is practised on a large scale in the USA, where so many young Europeans took their first steps in experimental science? - Without the conscientious clinical work done in Central Europe and the valuable experience gained there? - Without, finally, the sober and critical scientific approach, as fostered in the cool heads of Northern Europe for generations? None of these qualities is sufficient without the others, but together they are a source of strength. Ultimately, we hope, through sensible con centration of efforts (while maintaining variety), to overcome the lack of an integrated approach in experimental science and to prevent repetition of painful mistakes. In this regard, the first two ESKA congresses have brought us great advances. |
| varus valgus test: Orthopaedic Manual Physical Therapy Christopher H. Wise, 2015-04-10 Take an eclectic, evidence-based approach to orthopaedic manual therapy. From theory through practical application of soft tissue and joint mobilization techniques—this comprehensive resource delivers the depth and breadth of coverage you need to optimize patient outcomes through informed clinical decision-making as part of a comprehensive intervention regimen. |
