|
|
Home Care Kit
|
|
(L) Knee
|
Date of Exam
|
|
Pain Diagram
|
(R) Knee
|
|
Observation
|
Observation WNL
|
|
Bruising
|
[+] Bruising Comments
• • •
|
|
Swelling
|
[+] Swelling Comments
• • •
|
|
Redness
|
[+] Redness Comments
• • •
|
|
Atrophy
• • •
|
Aberrant Patellar Tracking
|
|
ABN Knee Posture
• • •
|
Observation Comments
|
|
Knee ROM Exam
|
ROM WNL
|
|
Flexion (150)
|
Flexion Symptoms
• • •
|
|
Extension (0)
|
Extension Symptoms
• • •
|
|
Internal Rotation (5)
|
IR Symptoms
• • •
|
|
External Rotation (5)
|
ER Symptoms
• • •
|
|
Motor Function
|
MMT WNL
|
|
Grade 5/5
• • •
|
Grade 4/5
• • •
|
|
Grade 3/5
• • •
|
Grade 2/5
• • •
|
|
Grade 1/5
• • •
|
Grade 0/5
• • •
|
|
Pain with MMT
• • •
|
|
|
Othopedic Tests
|
|
|
Patellar Apprehension
|
[+] Patellar Apprehension Test
• • •
|
|
Fouchet's Test
|
[+] Fouchet's Test
• • •
|
|
Clarke's Test
|
|
|
Bounce Home Test
|
[+] Bounce Home Test
• • •
|
|
Valgus Stress @ 0
|
[+] Valgus Stress @ 0
• • •
|
|
Valgus Stress @ 30
|
[+] Valgus Stress @ 30
• • •
|
|
Varus Stress @ 0
|
[+] Varus Stress @ 0
• • •
|
|
Varus Stress @ 30
|
[+] Varus Stress @ 30
• • •
|
|
Anterior Drawer
|
[+] Anterior Drawer
• • •
|
|
Posterior Drawer
|
[+] Posterior Drawer
• • •
|
|
Lachman's Test
|
[+] Lachman's Test
• • •
|
|
McMurray's Test
|
[+] McMurray's Test
• • •
|
|
Pivot Shift Test
|
[+] Pivot Shift Test
• • •
|
|
Hughston's Plica Test
|
|
|
Apley's Compression Test
|
|
|
Apley's Distraction Test
|
[+] Apley's Distraction Test
• • •
|
|
Hyperflexion Compression Test
|
[+] Hyperflexion Compression Test
• • •
|
|
Thessaly test (for meniscal injury)
|
|
|
Othopedic Tests Comments
|
|
|
DDX Impressions
|
|
