Lower Limb Injections

Published on 18/03/2015 by admin

Filed under Rheumatology

Last modified 18/03/2015

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Section 4 Lower Limb Injections

Examination of the lower limb

The capsular pattern is a set pattern of loss of motion for each joint. It indicates that there is some degree of joint capsulitis caused by degeneration, inflammation or trauma. There may be a hard endfeel in advanced capsulitis

Hip tests
In supine In prone  
Passive lateral rotation Passive extension  
medial rotation Resisted lateral rotation  
flexion medial rotation  
abduction knee extension  
adduction    
Resisted flexion    
abduction    
adduction    
Hip capsular pattern: most loss of medial rotation, less of flexion and abduction, least of extension
Knee tests    
Passive flexion Draw test  
extension Glide test  
valgus Meniscal tests  
varus Resisted extension  
rotation flexion  
medial rotation    
Knee capsular pattern: more loss of flexion than extension
Ankle and foot tests    
Ankle Subtalar Forefoot
Passive dorsiflexion Passive abduction Passive abduction
plantarflexion adduction adduction
eversion   extension
inversion   flexion
Resisted dorsiflexion    
plantarflexion    
eversion    
inversion    
Ankle/foot capsular patterns:
Ankle: More loss of plantarflexion than dorsiflexion
Subtalar joint: More loss of adduction
Forefoot: Loss of adduction, dorsiflexion and supination
Big toe: More loss of extension than flexion
Toes: More loss of flexion than extension

Hip joint

Acute or chronic capsulitis

Gluteal bursa

Chronic bursitis

Psoas bursa

Chronic bursitis