Overview

This is a guide to the diagnostic evaluation of knee injury and disease that shows all the presently known tests and examination procedures. The clear text and accompanying illustrations lead to a full understanding of the various possible procedures and their appropriate use and value. Special attention is given to clinical examination and differential diagnosis. Seperate sections of the book deal with injuries of the capsuloligamentous structures, the menisci and the femoropatellar joint. Here the lesser known but important examination techniques are included. Other sections map out in detail radiographic studies, MRI, sonography, and arthroscopy. The discussion of the machine evaluation of laxity and rare diagnostic procedures points the way through unknown territory. This unique reference is the perfect diagnostic companion for every knee specialist involved in clinical examination procedures.

Full Product Details

Author:   Terry C. Telger ,  John A. Feagin ,  Michael J. Strobel ,  Hans-Werner Stedtfeld
Publisher:   Springer-Verlag Berlin and Heidelberg GmbH & Co. KG
Imprint:   Springer-Verlag Berlin and Heidelberg GmbH & Co. K
Weight:   1.330kg
ISBN:  

9783540507109

ISBN 10:   3540507108
Pages:   356
Publication Date:   26 September 1990
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Hardback
Publisher's Status:   Active
Availability:   Out of stock  
The supplier is temporarily out of stock of this item. It will be ordered for you on backorder and shipped when it becomes available.

Table of Contents

Anatomy, Proprioception, and Biomechanics.- 1 Anatomy, Proprioreception, and Biomechanics.- 1.1 Introduction.- 1.2 Bony Structures.- 1.2.1 Femur.- 1.2.2 Patella.- 1.2.3 Tibia.- 1.3 Anterior Complex.- 1.3.1 Quadriceps Femoris Muscle.- 1.3.2 Medial and Lateral Retinacula.- 1.3.3 Infrapatellar Fad Pad.- 1.4 Central Complex.- 1.4.1 Anterior Cruciate Ligament.- 1.4.2 Posterior Cruciate Ligament.- 1.4.3 Anterior and Posterior Meniscofemoral Ligaments.- 1.4.4 Menisci.- 1.4.4.1 Medial Meniscus.- 1.4.4.2 Lateral Meniscus.- 1.5 Medial Complex.- 1.5.1 Medial Collateral Ligament.- 1.5.2 Medial Capsular Ligament.- 1.5.3 Posterior Oblique Ligament.- 1.5.4 Semimembranosus Muscle.- 1.5.5 Pes Anserinus.- 1.6 Posterior Complex.- 1.6.1 Posterior Capsule.- 1.6.2 Oblique Popliteal Ligament.- 1.6.3 Arcuate Popliteal Ligament.- 1.6.4 Popliteus Muscle.- 1.6.5 Gastrocnemius Muscle.- 1.7 Lateral Complex.- 1.7.1 Lateral Capsule, Lateral Capsular Ligament.- 1.7.2 Lateral Collateral Ligament.- 1.7.3 Iliotibial Tract.- 1.7.4 Biceps Femoris Muscle.- 1.8 Proprioception.- 1.8.1 Classification.- 1.8.2 Distribution of Proprioceptors in the Knee Joint.- 1.8.2.1 Anterior Cruciate Ligament.- 1.8.2.2 Medial Collateral Ligament.- 1.8.2.3 Meniscus.- 1.8.3 Therapeutic Implications.- 1.9 Biomechanics and Biometry.- 1.9.1 Basic Considerations.- 1.9.2 Analysis of an Unknown Biologic Motion System.- 1.10 Radiographic Anatomy.- 1.10.1 Anteroposterior Projection.- 1.10.2 Lateral Projection.- 1.10.3 Tangential Projection (Sunrise View).- 1.11 Congenital Anomalies and Malformations of Ligamentous Structures.- 1.12 Conclusion.- General Clinical Diagnosis.- 2 General Clinical Diagnosis.- 2.1 History.- 2.1.1 Time of Injury.- 2.1.2 Mechanism of Injury.- 2.1.3 Locking.- 2.1.4 Snapping.- 2.1.5 Pain.- 2.1.5.1 Reflex Sympathetic Dystrophy.- 2.1.5.2 Pain Orginating Outside the Knee.- 2.1.5.3 Knee Pain in Children.- 2.1.5.4 Chronic Knee Pain.- 2.1.6 Giving Way.- 2.2 Inspection.- 2.2.1 Open Injuries.- 2.2.2 Effusion and Other Swelling.- 2.2.3 Muscular Atrophy.- 2.2.4 Skin Changes.- 2.2.5 Loss of Extension.- 2.2.6 Spontaneous Posterior Drawer.- 2.2.7 Limb Axis.- 2.3 Function Testing.- 2.3.1 Mobility.- 2.3.2 Rigidity Tests.- 2.3.3 Muscular Function.- 2.3.4 Sensation.- 2.3.5 Circulation.- 2.4 Palpation.- 2.4.1 Intraarticular Effusion.- 2.4.2 Extraarticular Swelling.- 2.4.3 Intraarticular Phenomena.- 2.4.4 Local Pain and Tenderness.- 2.4.4.1 Anterior Pain and Tenderness.- 2.4.4.2 Lateral Pain and Tenderness.- 2.4.4.3 Medial Pain and Tenderness.- 2.4.4.4 Posterior Pain and Tenderness.- 2.4.5 Temperature.- 2.4.6 Scars.- 2.5 Aspiration of the Knee Joint.- 2.5.1 Aspiration Technique.- 2.5.2 Examination of the Aspirate.- 2.5.3 Hemarthrosis.- Special Clinical Diagnosis.- 3 Evaluation of the Ligaments.- 3.1 Basic Principles.- 3.1.1 Theoretical Principles.- 3.1.1.1 Planes and Axes of Motion, Translation and Rotation.- 3.1.1.2 Motion Spectrum.- 3.1.1.3 Laxity and Instability.- 3.1.1.4 Increased Laxity.- 3.1.1.5 Laxity Parameters.- 3.1.2 Principles of the Examination.- 3.1.2.1 Doctor-Patient Relationship during the Examination.- 3.1.2.2 Timing the Examination.- 3.1.2.3 Active or Passive Tests.- 3.1.2.4 Evaluation of the End Point.- 3.1.2.5 Rules and Goals of the Examination.- 3.2 Valgus and Varus Test.- 3.3 Passive Anterior Drawer Tests.- 3.3.1 Anterior Drawer Test in 90 Flexion.- 3.3.2 Anterior Drawer Test in 90 Flexion in Various Positions of Tibial Rotation.- 3.3.2.1 Maximum Subluxation Test.- 3.3.3 LachmanTest.- 3.3.3.1 Prone Lachman Test.- 3.3.3.2 Stable Lachman Test.- 3.3.3.3 Graded Lachman Test.- 3.3.4 Finochietto's Sign.- 3.4 Dynamic Anterior Subluxation Tests (Pivot Shift Tests).- 3.4.1 Lemaire Test.- 3.4.2 Pivot Shift Test of Macintosh.- 3.4.3 Jerk Test of Hughston.- 3.4.4 Slocum Test.- 3.4.5 Losee Test.- 3.4.6 Noyes Test (Flexion Rotation Drawer Test).- 3.4.7 Flexion Extension Valgus Test.- 3.4.8 Nakajima Test (N Test).- 3.4.9 Martens Test.- 3.4.10 Graded Pivot Shift Test of Jakob.- 3.4.11 Modified Pivot Shift Test.- 3.4.12 Soft Pivot Shift Test.- 3.5 Medial Shift Test.- 3.6 Function Tests.- 3.6.1 Deceleration Test.- 3.6.2 Disco Test of Losee.- 3.6.3 Leaning Hop Test of Larson.- 3.6.4 Crossover Test of Arnold.- 3.6.5 Giving Way Test of Jakob.- 3.6.6 One-Leg Hop Test.- 3.6.7 Running in a Figure of Eight.- 3.6.8 Running Up and Down Stairs.- 3.7 Posterior Drawer Test.- 3.7.1 Soft Posterolateral Drawer Test.- 3.7.2 Reversed Lachman Test.- 3.7.3 Godfrey Test.- 3.8 Reversed Pivot Shift Test.- 3.8.1 Dynamic Posterior Shift Test.- 3.9 Active Laxity Tests.- 3.9.1 Active Quadriceps Test in 30 Flexion (Active Lachman Test).- 3.9.2 No-Touch Lachman Test (Active Quadriceps Test in 30 Flexion).- 3.9.3 Active Quadriceps Test in 90 Flexion.- 3.9.4 Modified Active Drawer Test in 90 Flexion.- 3.9.5 Quadriceps Neutral Angle Test of Daniel.- 3.9.6 Active Pivot Shift Test.- 3.9.7 Active Posterolateral Drawer Sign.- 3.10 External Rotation Recurvatum Test.- 3.11 Classification of Knee Instabilities.- 3.12 Isolated Ligament Ruptures.- 3.12.1 Isolated ACL Rupture.- 3.12.2 Isolated PCL Rupture.- 3.12.3 Isolated Ruptures of the Collateral Ligaments.- 3.13 Straight Instabilities.- 3.13.1 Medial and Lateral Instability.- 3.13.2 Anterior Instability.- 3.13.3 Posterior Instability.- 3.14 Complex Instabilities (Rotatory Instabilities).- 3.14.1 Anteromedial Instability.- 3.14.2 Anterolateral Instability.- 3.14.3 Posterolateral Instability.- 3.14.4 Posteromedial Instability.- 3.15 Conclusion.- 4 Evaluation of the Menisci.- 4.1 Classification.- 4.2 Symptoms.- 4.3 Discoid Meniscus and Meniscal Cysts.- 4.3.1 Discoid Meniscus.- 4.3.2 Meniscal Cysts.- 4.4 Meniscus Tests.- 4.4.1 Joint Line Tenderness.- 4.4.2 Hyperflexion and Hyperextension.- 4.4.3 Medial and Lateral Translation.- 4.4.4 Steinmann I Sign.- 4.4.5 Steinmann II Sign.- 4.4.6 Payr's Sign.- 4.4.7 Bohler's Sign.- 4.4.8 Kromer's Sign.- 4.4.9 Bragard's Sign.- 4.4.10 Merke'sSign.- 4.4.11 McMurrayTest.- 4.4.12 Fouche's Sign.- 4.4.13 Childress'Sign.- 4.4.14 Apley Test.- 4.4.15 Medial-Lateral Grinding Test.- 4.4.16 Rotational Grinding Test.- 4.4.17 Cabot's Sign.- 4.4.18 Finochietto's Sign.- 4.4.19 Turner's Sign.- 4.4.20 Tschaklin's Sign.- 4.5 Reduction of the Menisci.- 4.5.1 Kulka's Maneuver.- 4.5.2 Popp's Maneuver.- 4.5.3 Jones' Maneuver.- 4.5.4 Winkel's Maneuver.- 4.5.5 Follow-up Treatment.- 5 Evaluation of the Femoropatellar Joint.- 5.1 Femoropatellar Pain Syndrome (Anterior Knee Pain).- 5.1.1 Symptoms.- 5.1.2 Pathogenic Factors.- 5.1.3 Diagnostic Tests.- 5.1.3.1 Assessment of Laxity.- 5.1.3.2 Patellar Mobility.- 5.1.3.3 Patellar Tracking.- 5.1.3.4 Muscle Tightness.- 5.1.3.5 Hyperpression Test.- 5.1.3.6 Facet Tenderness.- 5.1.3.7 Zohlen's Sign.- 5.1.3.8 Crepitation Test.- 5.1.3.9 Frund's Sign.- 5.1.3.10 Tuning Fork Test.- 5.1.4 Therapeutic Implications.- 5.2 Patellar Fracture.- 5.3 Patellar Dislocation.- 5.3.1 Fairbank's Apprehension Test.- 5.4 Osteochondritis dissecans of the Patella.- Special Diagnostic Procedures.- 6 Radiographic Examination.- 6.1 Standard Radiographic Examination.- 6.1.1 Bony Ligament Avulsions and Ossifications.- 6.1.2 Rauber's Sign.- 6.1.3 Patellar Position.- 6.1.3.1 Patella alta.- 6.1.3.2 Patella baja.- 6.2 Patellar Sunrise Views.- 6.3 Tunnel View.- 6.4 Oblique Views.- 6.5 Functional Views.- 6.5.1 Weight-Bearing Radiographs.- 6.5.1.1 Rosenberg View.- 6.5.2 Maximum Flexion View.- 6.6 Arthrography.- 6.7 Tomography.- 6.8 Computed Tomography.- 6.9 Xeroradiography.- 6.10 Angiography, Digital Subtraction Angiography.- 6.11 Stress Radiographs.- 6.11.1 Advantages, Disadvantages, and Indications.- 6.11.2 Manual and Semimanual Techniques.- 6.11.3 Machine Techniques.- 6.11.4 Standardized Stress Radiographs.- 6.11.5 Measuring Techniques.- 6.12 Radiographic Documentation of Active Laxity Tests.- 6.12.1 Active Lachman Test (Active Quadriceps Test in 30 Flexion).- 6.12.2 Modified 90 Active Drawer Test.- 7 Magnetic Resonance Imaging.- 7.1 Instrumentation.- 7.1.1 Pulse Sequences.- 7.2 Menisci.- 7.3 Cruciate Ligaments.- 7.3.1 Anterior Cruciate Ligament.- 7.3.2 Posterior Cruciate Ligament.- 7.4 Cartilage.- 7.5 Periarticular Soft Tissues.- 7.6 Synovial Membrane.- 7.7 MR Arthrography.- 7.8 Concluding Remarks.- 8 Sonography.- 8.1 Instrumentation.- 8.2 Examination Procedure.- 8.3 Menisci.- 8.4 Cruciate Ligaments.- 8.5 Collateral Ligaments.- 8.6 Femoropatellar Joint.- 8.7 Cartilage.- 8.8 Patellar Ligament.- 8.9 Problems in Sonography.- 8.10 Outlook.- 9 Machine Evaluation of Laxity.- 9.1 Requirements.- 9.2 Evaluation of Varus-Valgus Laxity.- 9.3 Evaluation of Rotatory Laxity.- 9.4 Evaluation of Anterior-Posterior Laxity.- 9.4.1 Problem of the Neutral Position.- 9.4.2 Apparatus.- 9.5 Goniometers and Complex Testing Apparatus.- 9.6 Graphic Representation of Laxity Values.- 9.6.1 Two-Dimensional Representation of Laxity.- 9.6.2 Three-Dimensional Representation of Laxity.- 9.7 Conclusion.- 10 Rare Diagnostic Procedures.- 10.1 Radionuclide Scanning.- 10.2 Thermography.- 10.3 Phonoarthrography.- 10.4 Vibration Arthrography.- 11 Arthroscopy.- 11.1 Historical Background.- 11.2 Equipment.- 11.2.1 Arthroscopes.- 11.2.2 Video System.- 11.2.3 Probe.- 11.2.4 Documentation.- 11.3 Preparation.- 11.3.1 Positioning.- 11.3.2 Draping the Leg.- 11.3.3 Irrigation System.- 11.4 Portals.- 11.4.1 Arthroscopic Portal.- 11.4.2 Instrument Portal.- 11.4.2.1 Creation of the Instrument Portal.- 11.4.2.2 Location of the Instrument Portal.- 11.4.3 Triangulation.- 11.5 Orientation and Systematic Joint Inspection.- 11.6 Arthroscopic Anatomy and Pathologic Findings.- 11.6.1 Retropatellar Space.- 11.6.2 Suprapatellar Pouch.- 11.6.2.1 Synovium.- 11.6.2.2 Suprapatellar Plica.- 11.6.3 Lateral Recess.- 11.6.4 Patellofemoral Joint.- 11.6.5 Medial Compartment.- 11.6.5.1 Mediopatellar Plica.- 11.6.5.2 Medial Meniscus.- 11.6.5.3 Medial Femorotibial Joint.- 11.6.6 Intercondylar Notch.- 11.6.6.1 Infrapatellar Plica.- 11.6.6.2 Anterior Cruciate Ligament.- 11.6.7 Lateral Compartment.- 11.6.7.1 Lateral Meniscus.- 11.6.7.2 Popliteal Hiatus.- 11.7 Problem Situations.- 11.7.1 Yellow-Out, White-Out.- 11.7.2 Red-Out.- 11.7.3 Extravasation of Fluid.- 11.8 Complications.- 11.9 Indications for Diagnostic Arthroscopy.- 11.9.1 Contraindications to Arthroscopy.- 11.10 Capabilities of Arthroscopic Surgery.- Terminology and Definitions.- 12 Terminology and Definitions.- 12.1 Laxity.- 12.1.1 Passive Laxity Tests.- 12.1.2 Active Laxity Tests.- 12.1.3 Machine Laxity Tests.- 12.2 Instability.- 12.3 Motion.- 12.4 Displacement.- 12.4.1 Rotation.- 12.4.2 Translation.- 12.5 Coupled Displacement and Motion.- References.

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