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In case 1 you could use differing cervical and ankle positions during lumbar flexion and SLR to rule out any neural component >From: David Newman <[log in to unmask]> >Reply-To: - for physiotherapists in education and practice ><[log in to unmask]> >To: [log in to unmask] >Subject: Re: Two cases! >Date: Wed, 22 Sep 2004 14:59:58 +0100 > >In case two was there has there ever been an effussion? Dif Diagnosis >Meniscal/ Coronary ligt, Fat Pad Impingemnet -Hoffas. > >David Newman MCSP SRP >Chartered Physiotherapist >HANTSCARE > > > >-----Original Message----- >From: - for physiotherapists in education and practice >[mailto:[log in to unmask]] On Behalf Of Douglas M. White >Sent: 22 September 2004 14:37 >To: [log in to unmask] >Subject: Re: Two cases! > > >Case #1 Diff Dx hamstring tendonitis v stress/avulsion fx of ishial >tuberosity Case #2 Diff Dx meniscal tear > >******************************************************* >Dr. Douglas M. White > > > >-----Original Message----- >From: - for physiotherapists in education and practice >[mailto:[log in to unmask]] On Behalf Of nabil keshavjee >Sent: Monday, September 20, 2004 10:00 PM >To: [log in to unmask] >Subject: [PHYSIO] Two cases! > >Hi! >I'm really greatful there is someplace where I can >seek informed opinions regarding injuries I see and >have difficulty in treating. >Here are two that I have come across in recent weeks. >1. 42yo female, with left buttock pain. Intermittent >and sharp in nature, brought on when kicking during >high kicks in kickboxing, or in touching toes during >yoga. The pain does not occur on any normal daily >activities. Over the last 4 months this pain has not >changed. Pain does not radiate. No pins and needles >and no numbness. >On objective examination, lumbar flexion in standing >reproduces the pain, but repeated has makes no worse. >No effect from lumbar flexion. Squats do not >reproduce pain. Hip movements are normal. Pain is >reproduced at 95 degrees SLR. Resisted knee flexion >in sitting does not reproduce pain. Resisted knee >flexion in 95 degree SLR produces pain. Pain on >palpation of ischial tuberosity. >Any thoughts on possible treatment, or what else to >look at? >2. 30 yo female, with right medial knee pain. Pain >located around medial menisci. Pain produced most on >downhill runs, or walks. She is an avid runner, who >continues to try running but avoids running downills. >She has also found the walking in golf to also cause >alot of pain. >On postural observation, I have noticed pes cavus >bilaterally, but otherwise normal looking. I have >been unable to notice any oddities during her running >stride on treadmill. >Active, passive, and resisted movements do not >reproduce pain. Apprehensive during the mensical >tests but no pain or locking. Negative on all other >special tests. >Pain on palpation of right medial knee joint line >(just medial of patella). >My conclusion is meniscal tear, but is there something >else I should be looking at? > >All your help would be greatly appreciated. > >Nabil K. > >______________________________________________________________________ >Post your free ad now! http://personals.yahoo.ca _________________________________________________________________ Express yourself with cool new emoticons http://www.msn.co.uk/specials/myemo