Patient Case Study of Knee Injury

Patient Case Study of Knee Injury Short case description: 25 years old, female injured her right knee during basketball game. She left playing, required little assistance to get her car. PCP evaluated her, gave her non-steroidal anti-inflammatory with P.T referral. Brief summary of patient history: injury occurred when she planted her right leg and rotated to the right to evade a defender. She denied hearing a pop, she reported immediate pain was 8 out of 10 on a visual analog scale. Her current pain level is 5 out of 10. Patient came 2 days after injury, with knee swelling and locking. . Patient pain and mechanism of injury are consistent with a meniscus injury. Examination: Key Examination elements ICF category assessing Finding Pain Body structure function 5/10 with non-steroidal medication Effusion Body structure function Present (first grade) Active knee flexion Body structure function 10-110 Active knee extension Body structure function 0-10 Passive knee flexion Body structure function 10-120 Passive knee extension Body structure function 0-5 Manual Muscle test for knee flexion Body structure function 4/5 Manual Muscle test for knee extension Body structure function 3+/5 McMurrays test Health condition Positive with palpable click Joint line tenderness test Body structure function Positive with reproduction of pain on medial tibiofemoral joint Apleys compression test Health condition Positive with reproduction of pain consistent with medial meniscal injury Ambulation Activity limitation Assistive tool (single cane) Limping, antalgic gait squatting Activity limitation Quite a bit difficult Walking a mile Activity limitation Extreme difficulty Going up or down   10 stairs Activity limitation Quite a bit difficulty Standing one hour Activity limitation Extreme difficulty Running over even ground Activity limitation Extreme difficulty Ability to kook at home kitchen participation-involvement Quite a bit difficulty Ability to attend social meetings participation-involvement Quite a bit difficulty Usual sports activity participation-involvement Extreme difficulty Assessment/evaluation: 25 Y/O female had right medial meniscus sprain with positive special Tests, pain, effusion, weakness, limited knee range of movement of flexion and extension and limited activities of daily living with inability to participate in usual sports activities. Interventions: physical therapy treatment include: Modalities to reduce pain (whirlpool, electric stimulation, and cryotherapy). Modalities to reduce knee effusion (whirlpool, taping, pulsed ultra sound, and static quadriceps drill exercise). Intervention to restore range of motion deficits: therapeutic exercise progression, joint mobilization/ manual therapy. Therapeutic exercise to restore muscular strength and aerobic fitness. Functional strengthening exercise to return to previous level of function and participate in usual sports routine. Outcomes: After 7 weeks of rehabilitation patient get improved with following outcomes: Outcome ICF category Changes at D/C Pain Body structure function 2/10 with strenuous activity Effusion Body structure function Absent Active knee flexion Body structure function 0-140 Active knee extension Body structure function 0 Passive knee flexion Body structure function 0-140 Passive knee extension Body structure function 0 Manual Muscle test for knee extension/ flexion Body structure function 5/5 McMurrays test Health condition , disease, injury negative Joint line tenderness test Body structure function negative Apleys compression test Health condition , disease, injury negative Ambulation Activity limitation Normal gait without cane squatting Activity limitation No difficulty Walking a mile Activity limitation No difficulty Going up or down   10 stairs Activity limitation No difficulty Standing one hour Activity limitation No difficulty Running over even ground Activity limitation No difficulty Usual sports activity participation-involvement No difficulty Ability to attend social meetings participation-involvement Participating with no difficulty Ability to kook at home kitchen participation-involvement Participating with no difficulty LEFS SCALE activity Changes at D/C 20 points improvement to be 76/80 After 7 weeks of successful rehabilitation, patient was able to participate in routine sports activities and her daily living with no need to more medical or physical therapy assistance.