TAILIEUCHUNG - Clinical Tests for the Musculoskeletal System - part 10

Đánh giá huyết khối tĩnh mạch sâu. Thủ tục: Bệnh nhân nằm ngửa. Giám khảo thang máy chân bị ảnh hưởng và nhanh chóng dorsiflexes bàn chân của bệnh nhân với đầu gối mở rộng. Động tác này lặp đi lặp lại với đầu gối của bệnh nhân uốn cong trong khi giám khảo đồng thời palpates bê. | 250 Venous Thrombosis Homans Test Assesses deep venous thrombosis. Procedure The patient is supine. The examiner lifts the affected leg and rapidly dorsiflexes the patient s foot with the knee extended. This maneuver is repeated with the patient s knee flexed while the examiner simultaneously palpates the calf. Assessment Pain occurring upon dorsiflexion of the foot with the knee extended and flexed indicates thrombosis. Calf pain with the knee extended can also be caused by intervertebral disk disease radicular symptoms or muscle contractures. Fig. 259 Homans test a dorsiflexion of the foot with the knee extended b dorsiflexion of the foot with the knee flexed Buckup Clinical Tests for the Musculoskeletal System 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Occlusive Arterial Disease Occlusive arterial disease is often associated with orthopedic disorders. Notably nearly 90 of all cases of obliterative arteriosclerosis involve exclusively the lower extremities. Prior to treating the actual orthopedic disorder the physician must take care to exclude or identify any possible arterial ischemic disorders. After obtaining a detailed history a diagnosis can usually be made on the basis of inspection palpation and specific function tests and usually will not require the use of any diagnostic technology. Weakened or absent arterial pulse cool and pale skin or cyanotic skin patches of erythema and trophic disturbances are signs of occlusive arterial disease. Ulceration and gangrene are signs of advanced disease. Where typical symptoms of intermittent claudication calf pain after walking short distances are present determining the maximum distance the patient can walk without experiencing these symptoms can help in estimating the severity of the disorder Fontaine classification of the severity of occlusive arterial disease . The differential diagnosis of intermittent claudication must include spinal claudication from compression of the .

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