OVERZICHT DIAGNOSTIEK
Knie
(Diagnostiek 1, 3, 6)
Anja van Middelkoop
Fysiotherapie
,Inhoudsopgave
Functieonderzoek...................................................................................................................................3
Zwelling..................................................................................................................................................5
Strijktest.................................................................................................................................................5
Fractuur..................................................................................................................................................6
Ottawa Knee Rules.................................................................................................................................6
Voorste kruisband (VKB).........................................................................................................................7
Lachman.................................................................................................................................................7
Voorste schuiflade..................................................................................................................................7
Pivot shit test..........................................................................................................................................8
VKB cluster.............................................................................................................................................8
Achterste kruisband (AKB)......................................................................................................................9
Achterste-schuiflade...............................................................................................................................9
Step-offtest.............................................................................................................................................9
Actieve-quadricepstest.........................................................................................................................10
Superficiale mediale collaterale ligament (sMCL).................................................................................11
Valgus-stresstest (20°)..........................................................................................................................11
Posteromediaal complex (PMC)...........................................................................................................12
Valgus-stresstest (20°)..........................................................................................................................12
Valgus-stresstest (0°)............................................................................................................................12
AMRI-test (AnteroMedial Rotatory Instability).....................................................................................13
Dial-test (30°)........................................................................................................................................13
Laterale collaterale ligament (LCL).......................................................................................................14
Varus-stresstest (20°)...........................................................................................................................14
Posterolateraal complex (PLC)..............................................................................................................15
Varus-stresstest (20°)...........................................................................................................................15
Varus-stresstest (0°).............................................................................................................................15
Dial-test (30° en 90°)............................................................................................................................16
Meniscus..............................................................................................................................................17
McMurray.............................................................................................................................................17
JLT-test (Joint Line Tenderness)............................................................................................................17
Passieve flexie......................................................................................................................................18
Passieve extensie..................................................................................................................................18
Kraakbeen.............................................................................................................................................19
,JLT-test (Joint Line Tenderness)............................................................................................................19
Tractus Iliotibialis Frictie Syndroom (Runners knee).............................................................................20
Eccentric step test................................................................................................................................20
Test van Renne.....................................................................................................................................20
Noble Test............................................................................................................................................21
Thomas test..........................................................................................................................................21
Ober test...............................................................................................................................................22
Artrose..................................................................................................................................................23
Artrose cluster......................................................................................................................................23
Patellatendinopathie (Jumpers knee)...................................................................................................24
Single leg decline squat........................................................................................................................24
M. Osgood Schlatter.............................................................................................................................25
Single leg decline squat........................................................................................................................25
Eccentric step test................................................................................................................................25
Patellar apprehension-test...................................................................................................................26
Test van Renne.....................................................................................................................................26
Noble Test............................................................................................................................................26
Thomas test..........................................................................................................................................27
Ober test...............................................................................................................................................27
Patellofemorale pijnsyndroom.............................................................................................................29
Eccentric step test................................................................................................................................29
Patellar apprehension-test...................................................................................................................29
Test van Renne.....................................................................................................................................29
Noble Test............................................................................................................................................30
Thomas test..........................................................................................................................................30
Ober test...............................................................................................................................................31
, Functieonderzoek
Bewegingen: flexie, extensie, endorotatie, exorotatie
1. Inspectie (o.a. roodheid, onregelmatigheden huid)
2. Oriënterende palpatie (op vochtigheid, temperatuur en zwelling)
3. Actief onderzoek (functionele oriënterende bewegingen)
Instructie (praatje, plaatje, daadje)
Uitvoering:
Lokalisatie beweging voor betreffende gewricht binnen osteokinematisch
assenstelsel
Eventuele correcties:
o Bij beweging buiten descriptief anatomisch assenstelsel
o Bij compensaties in nevengewrichten
o Bij niet behalen van de eindstand
Vergelijk links – rechts!
Geeft informatie over:
Bewegingsverloop, coördinatie, compensaties
Bewegingsuitslag (hoekmeting m.b.v. goniometer)
Klachtenprovocatie (soort pijn, waar (lokalisatie), wanneer, herkenbaarheid)
Bijkomende geluiden
4. Passief onderzoek
Instructie
Uitvoering:
Uitgangshouding patiënt t.a.v. comfort
Lokalisatie d.m.v. inspectie/palpatie
Handvatting:
o Fixatie ‘os fixum’ – zo dicht mogelijk proximaal van het gewricht
o Handvatting ‘os mobilé’ – zo distaal mogelijk (zonder
tussenliggend gewricht)
o Bewegingen uitvoeren volgens descriptief anatomisch
assenstelsel
Vergelijk links – rechts!
Geeft informatie over:
Knie
(Diagnostiek 1, 3, 6)
Anja van Middelkoop
Fysiotherapie
,Inhoudsopgave
Functieonderzoek...................................................................................................................................3
Zwelling..................................................................................................................................................5
Strijktest.................................................................................................................................................5
Fractuur..................................................................................................................................................6
Ottawa Knee Rules.................................................................................................................................6
Voorste kruisband (VKB).........................................................................................................................7
Lachman.................................................................................................................................................7
Voorste schuiflade..................................................................................................................................7
Pivot shit test..........................................................................................................................................8
VKB cluster.............................................................................................................................................8
Achterste kruisband (AKB)......................................................................................................................9
Achterste-schuiflade...............................................................................................................................9
Step-offtest.............................................................................................................................................9
Actieve-quadricepstest.........................................................................................................................10
Superficiale mediale collaterale ligament (sMCL).................................................................................11
Valgus-stresstest (20°)..........................................................................................................................11
Posteromediaal complex (PMC)...........................................................................................................12
Valgus-stresstest (20°)..........................................................................................................................12
Valgus-stresstest (0°)............................................................................................................................12
AMRI-test (AnteroMedial Rotatory Instability).....................................................................................13
Dial-test (30°)........................................................................................................................................13
Laterale collaterale ligament (LCL).......................................................................................................14
Varus-stresstest (20°)...........................................................................................................................14
Posterolateraal complex (PLC)..............................................................................................................15
Varus-stresstest (20°)...........................................................................................................................15
Varus-stresstest (0°).............................................................................................................................15
Dial-test (30° en 90°)............................................................................................................................16
Meniscus..............................................................................................................................................17
McMurray.............................................................................................................................................17
JLT-test (Joint Line Tenderness)............................................................................................................17
Passieve flexie......................................................................................................................................18
Passieve extensie..................................................................................................................................18
Kraakbeen.............................................................................................................................................19
,JLT-test (Joint Line Tenderness)............................................................................................................19
Tractus Iliotibialis Frictie Syndroom (Runners knee).............................................................................20
Eccentric step test................................................................................................................................20
Test van Renne.....................................................................................................................................20
Noble Test............................................................................................................................................21
Thomas test..........................................................................................................................................21
Ober test...............................................................................................................................................22
Artrose..................................................................................................................................................23
Artrose cluster......................................................................................................................................23
Patellatendinopathie (Jumpers knee)...................................................................................................24
Single leg decline squat........................................................................................................................24
M. Osgood Schlatter.............................................................................................................................25
Single leg decline squat........................................................................................................................25
Eccentric step test................................................................................................................................25
Patellar apprehension-test...................................................................................................................26
Test van Renne.....................................................................................................................................26
Noble Test............................................................................................................................................26
Thomas test..........................................................................................................................................27
Ober test...............................................................................................................................................27
Patellofemorale pijnsyndroom.............................................................................................................29
Eccentric step test................................................................................................................................29
Patellar apprehension-test...................................................................................................................29
Test van Renne.....................................................................................................................................29
Noble Test............................................................................................................................................30
Thomas test..........................................................................................................................................30
Ober test...............................................................................................................................................31
, Functieonderzoek
Bewegingen: flexie, extensie, endorotatie, exorotatie
1. Inspectie (o.a. roodheid, onregelmatigheden huid)
2. Oriënterende palpatie (op vochtigheid, temperatuur en zwelling)
3. Actief onderzoek (functionele oriënterende bewegingen)
Instructie (praatje, plaatje, daadje)
Uitvoering:
Lokalisatie beweging voor betreffende gewricht binnen osteokinematisch
assenstelsel
Eventuele correcties:
o Bij beweging buiten descriptief anatomisch assenstelsel
o Bij compensaties in nevengewrichten
o Bij niet behalen van de eindstand
Vergelijk links – rechts!
Geeft informatie over:
Bewegingsverloop, coördinatie, compensaties
Bewegingsuitslag (hoekmeting m.b.v. goniometer)
Klachtenprovocatie (soort pijn, waar (lokalisatie), wanneer, herkenbaarheid)
Bijkomende geluiden
4. Passief onderzoek
Instructie
Uitvoering:
Uitgangshouding patiënt t.a.v. comfort
Lokalisatie d.m.v. inspectie/palpatie
Handvatting:
o Fixatie ‘os fixum’ – zo dicht mogelijk proximaal van het gewricht
o Handvatting ‘os mobilé’ – zo distaal mogelijk (zonder
tussenliggend gewricht)
o Bewegingen uitvoeren volgens descriptief anatomisch
assenstelsel
Vergelijk links – rechts!
Geeft informatie over:
