Knee Pain Kid

By | January 21, 2018

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Pediatric Orthopedic Exams The Knee

gt;gt; OK. SO I'M DR. GANLEY,TED GANLEY, FROM THE CHILDREN'SHOSPITAL OF PHILADELPHIA. I'M AN ORTHOPEDIC SURGEON. I'LL BE DEMONSTRATINGA KNEE EXAM. SO, WELCOME. WE'LL BE CHECKINGYOUR KNEE TODAY. OK.

AND SO WE'LL START WITH THEGAIT PORTION OF THE EXAM. SO WE WATCH HIM WALK FORUS, AND WE MAKE SURE HE HAS LEVEL SHOULDERS,LEVEL PELVIS, AND A SYMMETRICHEELTOE GAIT. WE LOOK AT HIS LOWEREXTREMITIES AND MAKE SURE HE DOESN'T HAVE ASIGNIFICANT VARUS OR VALGUS, MEANING BOWLEGGED OR KNOCKKNEED, AND WE LOOK AT HIS FOOTPROGRESSION ANGLE TO SEE IF

HIS FEET TURN INWARD OROUTWARD DURING HIS GAIT. AND MAKE SURE HE DOESN'THAVE ANY ANTALGIC COMPONENT OF HIS GAIT OR PAINFULOR STIFF LEGGED GAIT. SO AFTER WE WATCHTHE PATIENT WALK, WE OBSERVE THEMSTANDING, AND WE MAKE SURE, AGAIN, THEY HAVE ALEVEL SHOULDER AND PELVIS, MAKE SURE THEY HAVE .WE LOOK FOR THEIR ALIGNMENT. DO THEY HAVEVARUS OR VALGUS,

MEANING BOWLEGGED OR KNOCKKNEED. YOU CAN BRINGYOUR FEET TOGETHER. AND SO HE HASAPPROPRIATE ALIGNMENT. AND HIS PATELLA, HIS KNEECAPSFACE FORWARD AS WELL. OK. SO WE'LL HAVE YOU LIEFACE DOWN THEN FOR YOU. AND THEN SCOOT BACKTOWARD ME JUST A LITTLE BIT. AND THEN WE'LLCHECK HIP ROTATION,

AND SO WE'LL BRING THEFEET UP TO 90 DEGREES, THEN WE'LL INTERNALLYROTATE THE HIPS. AND HE INTERNALLY ROTATES ONTHE ORDER OF 60 DEGREES, AND WE'LL COME TO NEUTRAL,AND HE EXTERNALLY ROTATES 45 DEGREES. SO HE HAS LITTLEFEMORAL INVERSION, WHICH IS MORE INTERNALROTATING THAN EXTERNAL ROTATION. AND THEN WE'LLCHECK HIS LOWER LEGS.

AND HE HAS ANEUTRAL FOOTTHIGH ANGLE — THE LINE LONGITUDINAL ACCESSOF THE FEMUR RELATIVE TO THE FOOT — SO THAT'S A 0DEGREEFOOTTHIGH ANGLE, OR HE CAN HAVE EXTERNALROTATION OR INTERNAL ROTATION OF THE LOWER LEGS. AND HE HAS A 0DEGREEFOOTTHIGH ANGLE, AND HE ALSO HAS A STRAIGHTLATERAL BORDER OF EACH FOOT. SO WE'LL BE DEMONSTRATINGAREAS OF POINT TENDERNESS,

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