Teaching block: Musculoskeletal Examination Corey Dean MD

Objectives

• To review the key components of a musculoskeletal

examination including special tests

• To discuss and practice the knee and shoulder examination

• To review top 5 sports injuries for the shoulder and knee

Key Components of the Musculoskeletal Examination

1. Inspection

2. Palpation

3. Range of Motion

4. Strength

5. Neurovascular

6. Special Tests

Musculoskeletal Examination

• Shoulder:

• Rotator cuff testing

• Subacromial bursa

• Bicep tendon

• Acromioclavicular joint

• Instability

• Labral Injury

Shoulder Anatomy

• Glenoid labrum

• Rotator cuff muscles

• Shoulder is vulnerable to injury and age-related degenerative changes due to its large ROM.

Shoulder Exam: Special Tests

Hawkins & Neer Impingement

Empty Can Test & External ROM Resistance

Dropped Arm Test & Painful Arc

Musculoskeletal Examination

• Knee:

• Patellofemoral knee joint

• Ligamentous

• Meniscal

Knee Anatomy • Four Bones

• Three compartments

• Three articulations

• Stability: menisci (medial,

lateral), anterior/posterior cruciate ligaments, medial/lateral collateral ligaments.

Knee Exam: Special Tests

Anterior Drawer and Lachman’s

Valgus & Varus Stress Test

McMurray Test & Joint Line Tenderness

Thessaly Test

Musculoskeletal Examination

• Low back:

• Nonspecific vs. radiculopathy/spinal stenosis vs. other systemic causes

• Disc herniation

• Fracture

• Cancer

• Infection

• SI joint dysfunction

Back Exam: Special Tests

Lumbar Spine Anatomy

Straight Leg & Crossed Leg test

FABER Test

Leg Length Discrepency

Top 5 Sports Medicine Dysfunctions & Take Home Points • Shoulder

1. Rotator cuff injury

2. Impingement syndrome

3. AC joint sprain and separation

4. Shoulder instability

5. Bicep tendonitis

• Knee

1. Patellofemoral knee syndrome

2. Liganentous injury

3. Meniscal injury

4. Osteoarthritis

5. Apophysitis and bursitis

Top 5 Sports Medicine Dysfunctions & Take Home Points

• Back

1. Degenerative joint disease

2. Lumbar strain

3. Herniated disc

4. Compression fracture

5. SI Joint instability

Top 5 Sports Medicine Dysfunctions & Take Home Points