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首页> 外文期刊>Physiotherapy research international: the journal for researchers and clinicians in physical therapy >Acute knee haemarthrosis: a case report describing diagnosis and management for a patient on anticoagulation medication.
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Acute knee haemarthrosis: a case report describing diagnosis and management for a patient on anticoagulation medication.

机译：急性膝关节炎：描述抗凝药物患者诊断和治疗的病例报告。

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Background and Purpose. A 63-year-old woman was referred to physical therapy with a 3 day history of constant anterior left knee pain that was atraumatic in nature. The patient was taking anticoagulation medication for chronic atrial fibrillation. Her international normalized ratio (INR) was within normal limits when assessed 3 weeks prior to her initial physical therapy evaluation. Method. Physical examination revealed an antalgic gait, moderate left knee effusion, limited painful knee range of motion, normal ligamentous testing and negative joint line or patellofemoral joint palpation. The patient was instructed in the use of a single-point cane, use of ice, positional comfort and relative rest from weight-bearing activities. Upon re-assessment 2 days later, the patient's knee pain and effusion had worsened despite compliance with day 1 instructions. Given that there was no clear mechanism of injury and the worsening nature of the disorder, the physical therapist discussed the case with the patient's physician, and immediate appointments for laboratory testing and potential knee aspiration were obtained. Results. Laboratory testing demonstrated that INR values had elevated to a supratherapeutic level of anticoagulation. Fluid from the patient's left knee was aspirated, revealing a haemarthrosis. The patient's symptoms immediately improved following aspiration. After suspending her anticoagulation medication dose for 1 day, her INR value returned to therapeutic range. She was symptom free within 3 weeks with physical therapy intervention and had remained symptom free at 1 year following the knee haemarthrosis. Conclusion. We recommend that physical therapists screen all patients for whether or not they are taking anticoagulation medications, especially before implementation of manual therapy or therapeutic exercise interventions. Copyright (c) 2010 John Wiley & Sons, Ltd.
机译：背景和目的。一名63岁的妇女因进行了3天的持续性左前膝关节疼痛史（无创性）而接受了物理治疗。该患者正在服用抗凝药物治疗慢性心房颤动。在进行首次物理治疗评估前3周评估她的国际标准化比率（INR）在正常范围内。方法。体格检查显示步态止痛，左膝中度积液，膝盖疼痛范围有限，韧带测试正常，joint关节或or股关节触诊阴性。指导患者使用单点拐杖，使用冰块，姿势舒适以及承重活动带来的相对休息。 2天后重新评估后，尽管遵守了第1天的指示，但患者的膝盖疼痛和积液已加重。鉴于尚无明确的伤害机制和疾病恶化的性质，物理治疗师与患者的医生讨论了此案，并立即任命了实验室检查人员和潜在的膝关节吸引患者。结果。实验室测试表明，INR值已升高至抗凝治疗上水平。病人左膝的液体被吸出，显示出血肿。抽吸后患者的症状立即得到改善。暂停抗凝药物剂量1天后，INR值恢复到治疗范围。她在接受物理疗法的3周内无症状，并且在膝关节置换术后1年一直没有症状。结论。我们建议理疗师对所有患者进行筛查，以了解他们是否正在服用抗凝药物，尤其是在实施手动疗法或治疗性运动干预措施之前。版权所有（c）2010 John Wiley＆Sons，Ltd.

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