Case Study 2

Case Study
Knee Osteoarthiritis
BPT Sem. VII
2021-2022
Submitted To – Submitted By -
Dr. Anita Sharma Anmol Williams
Asst. Professor BPT Sem
VII
SoMAS
Knee Osteoarthiritis
 A condition in which the meniscus of one knee wears

away.
 It causes bones to articulate with each other
resulting in pain, stiffness, crepitus, swelling and

formation of bone spurs.
 If left untreated, it can cause loss of mobility and
severe chronic pain.

Risk Factors
 Age – Increased wear and tear with age, and
decreased healing factor
 Weight – Increased weight of person leads to
increased pressure on knee meniscus leading to

rapid wear
 Gender – Women over 55y/o are more likely to have
OA than men over 55y/o

 Hereditary Factors – Conginital Deformities, etc.
Treatment
 Strengthening and stretching exercises

 CPM and ROM exercises
 PnF
 Weight Loss Programmes
 NSAIDs
 Diet Control and Regulation
 Surgery (As last resort)
Assessment Form
A. Demographic Data
 Name – Ms. Isha Malik
 Age - 30
 Gender - F
 Occupation – Travel Journalist
 Address – 123/45, New Delhi
 Contact No. – 98xxxxxx210
 Referral – Advertisement on Billboard
 Date of Assessment – 20th May, 2019
 Chief Complaint – Patient complaints of pain in left knee which keeps

persisting even after taking Painkillers and applying ointments.
Assessment Form
B. History
1. Medical History
 Past Illnesses – Mild Cold (few months ago)
 Past Surgeries – None
 Past Medications – None
 Current Medications – Painkillers
2. Personal History
 Tobacco Consumption – No
 Alcohol Cosumption – Yes
 Allergies – Pollen
Assessment Form
B. History
3. Family History
 Hereditary Conditions – Diabetic Father
 Familial Support – No close family
 Socio – Economic Background – Upper Middle
Class
4. Pain History
 Type of Pain – Sharp, Stabbing pain
 Nature of Pain – Benign, Non-Radiating Pain
 Duration of Pain – Chronic
Assessment Form
B. History
4. Pain History
 Onset of Pain – 2 Months ago, Insidious Pain
 Aggravating Factors – Exertion of Left Knee, Long duration of
activity or movement.
 Relieving Factors – Immobilization, NSAIDs, Ointments, Hotpacks
C. NPRS (Numerical Pain Rating Scale)
No Pain Unbearable Pain

0 – 1 – 2 – 3 – 4 – 5 – 6 – 7 – 8 – 9 – 10
Assessment Form
D. On Observation
 Gait – Limping Gait, Favoring Right Knee
 Posture – Forward bending, slight right deviation of
neck.
 Kyphosis – Slight Kyphosis of Cervical Spine Present
 Lordosis – None
 Built – Lean, Athletic Build
 Cadence – Slow Cadence (6-8 steps/10 seconds appx.)
E. On Examination
Assessment Form
E. On Examination
1. Vital Signs
 Heart Rate – 95 bpm
 Blood Pressure – 135/90 mmhg
 Respiratory Rate – 10 breaths/minute
 Temperature – 98F
2. On Palpation
 Irritability – pT. Allows Palpation but winces
 Swelling – Moderate Swelling around Left Anterior-Proximal
Tibia
 Temperature – Slightly warm
 Palpitation – Absent
 Texture – Smooth/Normal
Assessment Form
E. On Examination
2. On Palpation
 ROM (Affected Joint) – Impaired ROM (0-87~)
 DTR – 2+ (Average Response)
 Crepitus – Present
 Muscle Tone – Well Defined
3. Medical Imaging
 X-Ray – Reduced Meniscal Size in Left Meniscus
 MRI – Reduced Meniscal Fluid Volume in Left Meniscus
 CT Scan – N/A
4. Special Tests
 Mcmurray’s Test – Negative
Assessment Form
E. On Examination
5. MMT
 Grade 5 – Complete ROM against gravity with max. resistance
 Grade 4 – Complete ROM against gravity with min. resistance
 Grade 3 – Complete ROM against gravity
 Grade 2 – Complete ROM in gravity eliminated plane
 Grade 1 – Flicker of Contraction on palpation
 Grade 0 – No contraction present
 Patient displays Grade 5 till available ROM with mild discomfort.

Assessment Form
F. Initial Diagnosis
 Patient examination and medical imaging suggests possible
Osteoarthritis
G. Differential Diagnosis
 Meniscal Tear
 Osteoporosis
 Rheumatoid Arthritis
H. Treatment
 Week 1-2: Active-Passive stretches and CPM till edge of
available ROM, Manipulation and Traction, Cryotherapy, IFT
and US. Lessening strain on affected Knee by lifestyle
changes. Diet regulation.
Assessment Form
H. Treatment
 Week 2-3: Active Stretching and CPM till edge of
avaliable ROM, Strengthening and PnF Exercises,
Manipulation and Traction, Cryotherapy, IFT and US.
Lessening strain on affected Knee by lifestyle changes.
Diet regulation. Posture correction.
 Week 3-4: Active Stretching till end of functional ROM,
Strengthening and PnF Exercises, Manipulation and
Traction, Thermotherapy, IFT and US. Mild-Moderate
intensity Lower body Weight loss exercises. Diet
Regulation. Posture Correction.
Assessment Form
I. Short Term Goals
 Pain Reduction
 Swelling Reduction
 Increasing available ROM
 Posture Correction
 ADLs
J. Long Term Goals
 Pain Relief
 Restoration of Functional ROM
 ADLs
Assessment Form
K. Home Programme
 Self Stretching and Strengthening exercises.
 Posture Correction exercises.
 Weight Loss and Dietary regulation.
 Visit a medical practitioner for NSAIDs, if pain
becomes severe.
 Lessen the strain on affected knee by lifestyle
changes.

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Case Study

 A condition in which the meniscus of one knee wears

resulting in pain, stiffness, crepitus, swelling and

severe chronic pain.

increased pressure on knee meniscus leading to

OA than men over 55y/o

 Strengthening and stretching exercises

 Chief Complaint – Patient complaints of pain in left knee which keeps

C. NPRS (Numerical Pain Rating Scale)

No Pain Unbearable Pain

 Patient displays Grade 5 till available ROM with mild discomfort.

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