Knee Complaint

HPI: 

- Mechanism of injury 
- Acute traumatic, gradual, or spontaneous onset  
- Pop or tear with injury 
- Location of pain  
- Swelling (Y/N), if yes how long after injury ____ hrs 
- Knee clicking, catching, or locking 
- Give-way episodes 
- Provoking/alleviating factor 
- Effect on pt’s normal level of activity


PMH/PSHx:
-Previous history of knee injury/surgery: [select name="variable_1" value="yes|no"]
[textarea name="variable_1" default=""]

PE:

INSPECTION
Limping gait  [select name="variable_2 value= "Yes|No |Not examined"]
Weightbearing  [select name="variable_3" value="Yes|No |Not examined"]  
Swelling   [select name="variable_4" value="Yes|No |Not examined"]
Bruising   [select name="variable_5" value="Yes|No |Not examined"]
Atrophy   [select name="variable_6" value="Yes|No |Not examined"]  
Alignment  [select name="variable_7" value="Varus |Valgus |Normal"]
PALPATION
Medial jt line tenderness [select name="variable_8" value="Yes|No |Not examined"]Lateral jt line tenderness [select name="variable_9" value="Yes|No |Not examined"]
Tib tuberosity/Pat.tendon [select name="variable_10" value="Yes|No |Not examined"]MCL  [select name="variable_11" value="Yes|No |Not examined"]
LCL   [select name="variable_12" value="Yes|No |Not examined"]
IT band/Lat fem condyle [select name="variable_13" value="Yes|No |Not examined"]
Pes Anserine   [select name="variable_14" value="Yes|No |Not examined"]
Semi-membr/-tendinosus[select name="variable_15" value="Yes|No |Not examined"]  
Biceps femoris  [select name="variable_16" value="Yes|No |Not examined"]


ROM
Extension  [select name="variable_17" value="Full |Limited"]
Flexion  [select name="variable_18" value="Full |Limited"]


STRENGTH 
Extension  [select name="variable_19" value="Full |weak| painful"]
Flexion   [select name="variable_20" value="Full |weak| painful"]

NEUROVASCULAR
Sensation  [select name="variable_21" value="Yes|No |Not examined"]
Distal Pulses  [select name="variable_22" value="Yes|No |Not examined"] 

SPECIAL TESTS
Effusion   [select name="variable_23" value="Yes|No |Not examined"]
Warm/Cold/Warm [select name="variable_24" value="Yes|No |Not examined"]
Fluid wave medially [select name="variable_25" value="Yes|No |Not examined"]


Patellar testing  
Compression pain [select name="variable_26" value="Yes|No |Not examined"]
Patellar shrug pain [select name="variable_27" value="Yes|No |Not examined"]
Patellar apprehension [select name="variable_28" value="Yes|No |Not examined"]
Tenderness patella facets[select name="variable_29" value="Yes|No |Not examined"]Medial/Lateral glide [select name="variable_30" value="Abnormal|No |Not examined"]

Meniscal Tear Assessment   
McMurray test  [select name="variable_31" value="Yes|No |Not examined"]
Thessaly test  [select name="variable_32" value="Yes|No |Not examined"]  


Ligamentous tests   
Anterior drawer (ACL) [select name="variable_33" value="Yes|No |Not examined"] 
Posterior drawer (PCL) [select name="variable_34" value="Yes|No |Not examined"]  
Lachman (ACL) [select name="variable_35" value="Yes|No |Not examined"]  
Varus stress (LCL)[select name="variable_36" value="Yes|No |Not examined"] 
Valgus stress (MCL) [select name="variable_37" value="Yes|No |Not examined"]





A/P

DDX includes: [checkbox name="variable_1" value="Osteoarthritis| Patellofemoral syndrome |Patellar tendinopathy |Iliotibial band syndrome|Osgood-Schlatter syndrome| Knee contusion | ACL tear |PCL tear |MCL strain/tear | LCL strain/tear |Medial meniscus tear | Lateral meniscus tear |Patellar dislocation |Patella fracture "]

Given that patient, XXX will order imaging studies 
-Age 55 or older with acute trauma 
-Isolated tenderness of patella following trauma
-Tenderness at head of fibula 
-Inability to flex to 90 degrees following trauma 
-4 step ambulation (disregarding limp)