, Gewrichtsaandoeningen Meniscusletsel Plica syndromen Intra-articulaire adhesies Syndr van stieda&pellegrini
Anamnese - Pijn: vnl flex+ext ,lokale pijn -pijn: med zijde tijdens/na -Weinig/geen pijn in rust - Pijn en drukpijn thv med
-zwelling:gevolg v bloeding belasting -pijn buigen en strekken knie femurcondyl (vnl bij flexie)
-knie voelt zwak aan (onst) -Nachtpijn (verwijnt ext knie) - flexiebeperk: lig coll med
- klik, Blokkage -Doorzakkingsgevoel moet rekken: gt niet: calcific
- trauma? gn trauma: 45j: -Lange tijd zelfde houding
meniscus verliest kwaliteit -Hoorbare knap bij fl&ext
inspectie -matige hydrops(acasc), -Lichte hydrops:+ soms lokale roodheid
hematrose (vasc) -weinig atrofie M Q-ceps
- Zwelling
-Spieratrofie thv Q-ceps
Palpatie Hydroptesten: + Hydroptesten:+ soms lokale warmte
Drukpijn thv gewrichtsspleet Plica palpatietest:+
Functieonderzoek -/f/: hurken+ganzenpas: /p/: flexie&ext: mog beperkt -/p/ flexie: zeer beperkt -/p/: flexie: sterk beperkt
-/p/: pijn bij compr: flex (AH), flex-> ext: painful arc(30-90°) ext: meestal normaal valgustest in lichte flex: pijn
Ext (VH, springend eindg: BHS =inklem mediopat plica
MM) Exo: mog pijnlijk (inklem
Exo: (MM, Med M-lig) mediopat plica in gewr)
Endo: (LM, lat M-lig)
-/w/: pijnlijk i musc MM/LM
Ext (VH MM, LM),
flexie+exo(AH LM)
flexie+endo( AH MM of LM)
Toegevoegdonderzoek - Meniscust Thessaly: -Patellaverschuiving-> med dd: Syndroom van Stieda en -Rx: diagnose bevestigen
- Valgus/Varusstresstest bij 30° flexie: + pellegrini
-Mc murray test -MRI en artroscop: diagnose
-Test van Appley bevestigen
- Palpatietest Steinmann
-RX, artroscopie, MRI
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