Assignment task:
A 30-year-old male rugby player presents with pain in the anterior thigh of the right leg. He has noticeable swelling and ecchymosis present over the muscle belly of the quadricep-located at mid thigh region. He came into the clinic walking with a limp and reports having trouble flexing his knee all the way back. Upon examination, he is very point tender over that mid-thigh region. You measure his range of motion, with a goniometer, for flexion and get 120 degrees actively. Therefore, he lacks approximately 15 degrees of flexion in the affected leg. He does have full extension of the knee during the evaluation process. He has no radiating pain as the pain is localized to one area.
What other information would you want to know by asking questions, assessing and examining the patient?
Discuss what other information you would like to gather for example:
- Subjective questions referring to: pain scale/level, pain with a squat motion, past history, was there a direct hit to the thigh and/or a detailed mechanism, any change in pain or discoloration, timing of injury, movements that cause increased pain, have any treatments been done, any numbness or tingling into foot/toes, feel or hear a pop, constant pain or comes/goes,
- Observation inquiries involve: pain with extension, pt tenderness with movement, location of patella, pain with gait
- Testing: Myotomes/Dermatomes, modified Thomas Test, Quadricep Manual Muscle Testing, Ely's Test, Reflexive Testing, Straight Leg Raise Test
Possible MRI or Ultrasound and Xrays
- Differential Diagnoses: Anterior Compartment Syndrome, Quadricep Strain, ACL tear, Quadricep Contusion, Femoral shaft stress fracture, Quadricep Tendon Rupture