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首页> 外文期刊>Physiotherapy theory and practice >Differential diagnosis of knee pain following a surgically induced lumbosacral plexus stretch injury. A case report
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Differential diagnosis of knee pain following a surgically induced lumbosacral plexus stretch injury. A case report

机译：手术诱导的腰椎丛林弹伸损伤后膝关节疼痛的鉴别诊断。 案例报告

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Background and Purpose: Knee joint biomechanics requires an understanding of lower extremity (LE) segmental interactions. In some cases, knee pain may arise as a result of altered LE biomechanics; while in other cases, knee pain may stem from other causes, such as a peripheral nerve injury. Case Description: A 33-year-old woman presented via direct access for physical therapist (PT) examination with a chief complaint of left knee pain. The day after undergoing a dilation and curettage (D&C) procedure the patient had an acute onset of gait dysfunction. Over the next few days, the patient developed left anterior knee pain (7/10 at worst) in addition to a significant change in physical functioning (Lower Extremity Functional Scale [LEFS] 38/80). Physical examination revealed left LE weakness, altered sensation, and an absent Achilles deep tendon reflex. Outcomes: The patient's presentation was consistent with a lumbosacral plexus stretch injury, with S1 being most affected. A physiatrist was consulted and recommended initiating PT treatment with bi-weekly re-examination. The 6-week (14 visits) re-examination revealed abolished left knee pain and improved physical functioning (LEFS 66/80). Conclusion: Stretch injuries are a known complication of lithotomy positioning. Knowledge of this and the addition of a thorough examination allowed the PT to identify the possible cause of the patient's abrupt onset of left LE dysfunction. Regardless of mode of patient access, screening for referral is crucial and may include referral or, as in this case, consultation with other professionals.
机译：背景和目的：膝关节生物力学需要了解下肢（LE）节段性相互作用。在某些情况下，由于Le BiomoMensics改变，可能会出现膝关节疼痛;虽然在其他情况下，膝关节疼痛可能会源于其他原因，例如周围神经损伤。案例描述：一名33岁的女子通过直接访问物理治疗师（PT）检查，具有左膝盖疼痛的主要投诉。经历扩张后的一天和刮宫（D＆C）程序，患者患有步态功能障碍的急性发作。在接下来的几天内，除了物理功能的显着变化（下肢功能尺度[LEFS] 38/80）外，患者还在左侧膝关节疼痛（最差7/10）外。体检显示左侧弱点，感觉改变，并且缺席的阿基里斯深肌腱反射。结果：患者的介绍与腰骶丛拉伸损伤一致，S1受影响最大。咨询了一个物理学家，并推荐使用双周重新检查启动PT治疗。 6周（14次访问）重新检查显示废除左膝部疼痛和改善物理功能（LEFS 66/80）。结论：拉伸损伤是一种已知的岩体定位并发症。知识和添加彻底检查允许PT识别患者突然发作的可能原因左侧功能障碍。无论患者访问模式如何，筛选转诊都至关重要，可能包括转介或如在这种情况下，与其他专业人员协商。

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