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• • An overuse condition or injury of the knee that causes a painful bump and swelling on the shinbone below the knee. Affected muscles are with tendons connected to the tibial tuberosity or upper shin.

  Symptoms: pain and swelling below the kneecap, The pain usually gets worse with running, jumping, going up stairs, and walking up hills, Severe pain may lead to limping

  OSGOOD SCHLATTER DISEASE
• • Genu valgum, a condition in which the knees tilt inward while the ankles remain spaced apart

  Symptoms: knee or hip pain, foot or ankle pain, stiff or sore joints, a limp while walking

  KNOCK-KNEE DEFORMITY
• • a condition in which a person's legs curve outward at the knees

  Symptoms: An obvious gap between the knees when standing with the feet together, Knee or hip pain that is not related to an injury, Knee or hip pain that is not related to an injury, Difficulty walking or running, Instability in the knee

  BOW LEGGED DEFORMITY
• • injuries of the knee typically occur due to a sudden varus force to the knee and often present in combination with other ipsilateral ligamentous knee injuries (ie. PCL, ACL)

  Symptoms: can be suspected with increased varus laxity on physical exam

  ISOLATED LCL INJURY
• • Is a stretch, partial tear, or complete tear of the ligament on the inside of the knee. It is one of the most common knee injuries and results mostly from a valgus force on the knee. MCL injuries mostly occur after an impact on the outside of the knee, lower thigh or upper leg, when the foot is in contact with the ground, and unable to move.

  Symptoms: Pain directly over the ligament, Swelling and inflammation over the inside (medial) part of the knee, Severe cases patients will feel their knee “give out”, or buckle

  ISOLATED MCL INJURY
• • also known as a blown knee among other names, is an injury to the anterior cruciate ligament, medial collateral ligament, and meniscus. Analysis during the 1990s indicated that this 'classic' O'Donoghue triad is actually an unusual clinical entity among athletes with knee injuries

  Symptoms: A loud popping sound that comes from the tearing of ligaments within the joint, Extreme sharp pain and associated inflammation, Restricted movement including the ability to bend or stretch the knee.

  UNHAPPY/UNHOLY TRIAD OF O'DONOGHUE
• • one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus. 

  Symptoms: A popping sensation, Swelling or stiffness, Pain especially when twisting or rotating your knee, Difficulty straightening your knee fully, Feeling as though your knee is locked in place when you try to move it, Feeling of your knee giving way

  MENISCUS TEAR
• • a degenerative joint disease, in which the tissues in the joint break down over time. It happens when the cartilage that lines your joints is worn down or damaged and your bones rub together when you use that joint.

  Symptoms: Pain, Stiffness, Tenderness, Loss of flexibility, Loss of flexibility, Bone spurs, Swelling

  OSTEOARTHRITIS
• • Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their ACL. Causes of ACL tear are Changing direction rapidly, Stopping suddenly, Slowing down while running, Landing from a jump incorrectly, Direct contact or collision, such as a football tackle.

  Symptoms: Within 24 hours, your knee will swell. If you attempt to return to sports, your knee will probably be unstable, and you risk causing further damage to the meniscus of your knee., Loss of full range of motion, Tenderness along the joint line, Discomfort while walking

  ACL TEAR
• • Sudden and forceful turning, twisting and “cutting”. A direct blow to the outer side of your kneer. These are common in people who play certain sports like skiing, football, basketball and volleyball. It is also caused by squatting or lifting heavy objects, landing awkwardly on your knee after a jump, hyperextending your knee,

  Symptoms: popping sound and pain in knee, tenderness along the inner side of your knee, stiffness and swelling, Feeling like your knee is going to “give out” if you put weight on it, Feeling your knee joint lock or catch when you use it.

  MCL TEAR
• The head of the femur—that is, that part that is not intraacetabular—can be palpated on the anterior aspect of the thigh just inferior to the inguinal ligament and just lateral to the pulsating femoral artery. Tenderness over the head of the femur usually indicates the presence of arthritis of the hip joint.

  Symptoms: Tenderness over the head of the femur usually indicates the presence of arthritis of the hip joint

  TENDERNESS OF HEAD OF FEMUR AND ARTHRITIS OF HIP JOINT
• Commonly occur in the young and middle aged. The fracture line is extracapsular, and both fragments have a profuse blood supply. If the bone fragments are not impacted, the pull of the strong muscles will produce shortening and lateral rotation of the leg, as previously explained.

  Symptoms: direct trauma to femur in _ region

  TROCHANTERIC FRACTURE
• occurs in the elderly. ___ fractures are particularly common in women after menopause.

  Symptoms: minor trip or stumble, __ neck will fracture

  SUBCAPITAL FRACTURE
• Bursitis, or inflammation of a bursa, can be caused by acute or chronic trauma. An inflamed bursa becomes distended with excessive amounts of fluid and can be extremely painful. The bursae associated with the _ are prone to inflammation.

  Symptoms: acute or chronic trauma

  GLUTEUS MAXIMUS AND BURSITIS
• The _ and _ muscles may be paralyzed when _ involves the lower lumbar and sacral segments of the spinal cord. They are supplied by the superior gluteal nerve (L4 and 5 and S1). Paralysis of these muscles seriously interferes with the ability of the patient to tilt the pelvis when walking.

  Symptoms: paralyzed gluteus medius or medius (supplied by superior gluteal nerve)

  GLUTEUS MEDIUS AND MINIMUS AND POLIOMYELITIS
• The _ muscle can rupture in sudden violent extension movements of the knee joint. The muscle belly retracts proximally, leaving a gap that may be palpable on the anterior surface of the thigh. In complete rupture of the muscle, surgical repair is indicated.

  Symptoms: sudden extension movements of knee joint

  RUPTURE OF THE RECTUS FEMORIS
• Occurs when a sudden flexing force is applied to the knee joint when the quadriceps femoris muscle is actively contracting

  RUPTURE OF LIGAMENTUM PATELLAE
• In patients with cerebral palsy who have marked spasticity of the adductor group of muscles, it is common practice to perform a tenotomy of the adductor longus tendon and to divide the anterior division of the obturator nerve. In addition, in some severe cases, the posterior division of the obturator nerve is crushed. This operation overcomes the spasm of the adductor group of muscles and permits slow recovery of the muscles supplied by the posterior division of the obturator nerve.

  Symptoms: marked spasticity of the adductor group of muscles

  ADDUCTOR MUSCLES AND CEREBRAL PALSY
• The femoral nerve not only supplies the hip joint but, via the intermediate and medial cutaneous nerves of the thigh, also supplies the skin of the front and medial sides of the thigh. It is not surprising, therefore, for pain originating in the hip joint to be referred to the front and medial side of the thigh. The posterior division of the obturator nerve supplies both the hip and knee joints. This would explain why hip joint disease sometimes gives rise to pain in the knee joint.

  Symptoms: weak nerves supplying hip joint

  REFERRED PAIN FROM THE HIP JOINT
• The stability of the hip joint depends on the ball-and-socket arrangement of the articular surfaces and the strong ligaments. In __ of the hip, the upper lip of the acetabulum fails to develop adequately, and the head of the femur, having no stable platform under which it can lodge, rides up out of the acetabulum onto the gluteal surface of the ilium.

  Symptoms: unstable platform of femoral head and failed development of acetabulum

  CONGENITAL DISLOCATION OF THE HIP JOINT
• __ of the hip is rare because of its strength; it is usually caused by motor vehicle accidents. However, should it occur, it usually does so when the joint is flexed and adducted. The head of the femur is displaced posteriorly out of the acetabulum, and it comes to rest on the gluteal surface of the ilium (posterior dislocation). The close relation of the sciatic nerve to the posterior surface of the joint makes it prone to injury in posterior dislocations.

  Symptoms: usually caused by motor vehicle accidents

  TRAUMATIC DISLOCATION OF THE HIP
• The stability of the hip joint when a person stands on one leg with the foot of the opposite leg raised above the ground depends on three factors:

  ■ The gluteus medius and minimus must be functioning normally.

  ■ The head of the femur must be located normally within the acetabulum.

  ■ The neck of the femur must be intact and must have a normal angle with the shaft of the femur.

  If any one of these factors is defective, then the pelvis will sink downward on the opposite, unsupported side. The patient is then said to exhibit a _ _ sign

  HIP JOINT STABILITY AND TRENDELENBURG'S SIGN
• A patient with an inflamed hip joint will place the femur in the position that gives minimum discomfort—that is, the position in which the joint cavity has the greatest capacity to contain the increased amount of synovial fluid secreted. The hip joint is partially flexed, abducted, and externally rotated.

  Symptoms: inflamed hip joint with femur partially flexed, abducted and externally rotated

  ARTHRITIS OF THE HIP JOINT
• Because the bone lies within the quadriceps femoris tendon, little separation of the fragments takes place. Fracture of the _ as a result of indirect violence is caused by the sudden contraction of the quadriceps snapping the _ across the front of the femoral condyles. The knee is in the semiflexed position, and the fracture line is transverse.

  Symptoms: 

  • If direct violence, can be due to automobile accidents. 
  • If indirect violence, can be caused by sudden contraction of quadriceps or snapping of patella across the front of femoral condyles

  PATELLAR FRACTURE
• If only one bone is fractured, the other acts as a splint and displacement is minimal. Fractures of the shaft of the _ are often open because the entire length of the medial surface is covered only by skin and superficial fascia. Fractures of the distal third of the shaft of the _ are prone to delayed union or nonunion. This can be because the nutrient artery is torn at the fracture line, with a consequent reduction in blood flow to the distal fragment; the intact fibula prevents the proximal and distal fragments from coming into apposition.

  FRACTURES OF TIBIA AND FIBULA
• At the tibial condyles (tibial plateau), are common in the middle-aged and elderly. The tibial condyle may show a split fracture or be broken up, or the fracture line may pass between both condyles in the region of the intercondylar eminence. As a result of forced abduction of the knee joint, the medial collateral ligament can also be torn or ruptured.

  Symptoms: direct violence to lateral side of knee joint (ex: hit by the bumper of an automobile)

  FRACTURE OF PROXIMAL END OF TIBIA
• are considered with the ankle joint

  FRACTURE OF DISTAL END OF TIBIA
• The importance of the lower horizontal fibers of the vastus medialis and the large size of the lateral condyle of the femur in preventing lateral displacement of the patella has been emphasized. Congenital recurrent dislocations of the patella are caused by underdevelopment of the lateral femoral condyle. _ results from direct trauma to the quadriceps attachments of the patella (especially the vastus medialis), with or without fracture of the patella.Symptoms: direct trauma to the quadriceps attachments of the patella

  PATELLAR DISLOCATIONS
• A condition that causes tingling, numbness and burning pain in the outer part of the thigh. The condition is caused by compression of the lateral femoral cutaneous nerve

  MERALGIA PARESTHETICA
• Pain that travels along the path of the sciatic nerve. The sciatic nerve becomes impinged which travels down the leg. It often happens when a herniated disk or an overgrowth of bone puts pressure on the lumbar spine nerve roots.

  SCIATICA
• common peroneal nerve is affected, usually at the fibular head

  FOOT DROP
• person has problems with extension (Gluteus Maximus) and there is a need to place hand on the trunk to compensate.

  BACKWARD LURCHING
• Usually occurs when fatty tissue or a part of your bowel pokes through into your groin at the top of your inner thigh. It pushes through a weak spot in the surrounding muscle wall (abdominal wall) into an area called the femoral canal.

  Symptoms: sudden groin or thigh pain, abdominal pain, nausea

  FEMORAL HERNIA
• causes the piriformis muscle to have spasms, causes buttock pain, and inflammation

  PIRIFORMIS SYNDROME
• person has problems with extension (Gluteus Maximus) and there is a need to place hand on the trunk to compensate

  BACKWARD LURCHING
• Lordotic back

  ANTERIOR PELVIC TILT
• Flat back

  POSTERIOR PELVIC TILT
• Above knee cap and between skin; “housemaid’s knee”

  PRE-PATELLAR BURSITIS
• just below the knee cap; “clergyman’s knee”

  INFRAPATELLAR BURSITIS
• Impingement of tibial nerve, “baker’s cyst”

  POPLITEAL BURSITIS