Varus Stress Test - The Student Physical Therapist

Hey all, first case study I’m posting! I’m trying to make this slightly interactive, to encourage people to get involved and promote discussion. If people like this format let me know! More than happy to take suggestions / criticism, and adapt them moving forward.
Clinical Case Study 1
It’s 3:20pm on a Saturday in a quiet suburban neighbourhood, temperature is around 20C.
You are dispatched to an apartment block - non emergent “24yoM PT C/O L) lower leg pain for 1/24” - response time is 10 minutes.
On Arrival:
You find a 24YOM in obvious pain. Pt is 183cm and 84kg. Pt had been playing rugby earlier that day, and had taken a decent blow to the L) lower leg (anterior lower leg made contact with another player) - pt felt a slight pop/ odd sensation at the time. Although painful, after a few minutes he was able to return to play and continue the match. The pain continued, however was a dull ache around 3/10 - ice was applied following the game, pt had a few beers then returned home. It is now approximately 4 hours post injury - Pt states that over the past 1-2 hours, the pain has substantially increased, with the last 60 minutes being borderline unbearable (9/10). Pt reports weakness and difficulty moving the limb, with slight parasthesia distally. On basic inspection of the L) lower leg, there appears to be swelling generalised swelling, however more prominent over the anterior aspect - slight bruising noted. Patient is asking for pain relief at this point, and is obviously distressed.

PMHx - Asthma, R) #Radius 5y ago - plates in place
Medications - Salbutamol/Albuterol as needed
Allergies - Morphine, hayfever
Last oral intake - Lunch and beers 3-4 hours ago

VSS: - HR 106 - RR 22 - GCS 15 - BP 140/90 - SPO2 98%RA - ECG Sinus Tachycardia
EDIT / UPDATE WILL BE PROVIDED IN 12 HOURS WITH FURTHER INFORMATION
QUESTIONS:

List 3 differential diagnoses
What further information would you like? What additional assessments would you like to perform?
What are you currently concerned about (if anything)?

POST UPDATE: Sorry it’s a bit late, got recalled for a major incident!
A few of the main things asked for is a more detailed pain, neurovasuclar and musculoskeletal assessment.
Pain - I will be using the DOLORS acronym - Description: Generalised severe pain, alternating from deep burning pain to sharp stabbing pain upon movement. - Onset: Dull pain at time of injury, severity began increasing 2/24 ago - Location: Pain in left lower leg, spread throughout however particularly localised anteriorly. - Other Signs / Symptoms: Parasthesia/numbness in limb, slight nausea - Relieving / Provoking Factors: No relief, has attempted icing intermittently with no effect. Provoking factors include any movement or palpation of the affected limb. - Severity: Currently rated as a 9/10 on the pain scale. Pain seems out of proportion to injury.
Neurovascular Assessment: The 6 P’s! - Pain - Yes, severe and localised to lower L) leg - Pallor - Foot appears pale / dusky - Parasthesia - Present in limb distally, felt mainly in toes - Paralysis - Movement is present, however is limited and extremely painful. Weakness in L) limb. - Pulses - Unable to palpate a pedal pulse in the L) foot. - Poikilothermy - Left foot is cold to the touch
Musculoskeletal Assessment: Extremely painful to perform, but this is what you would find if you wished to assess. - Anterior & Posterior Drawer test of the L) knee is negative - Varus / Valgus stress tests are negative - Lower limb is grossly intact - tibia and fibula appear stable from what you can assess
QUESTIONS 1) What condition is now at the top of your differential? 2) Treatment? (Pre-hospital and in-hospital)
UPDATE WILL BE PROVIDED IN 6-8 HOURS

negative varus and valgus stress test video

varus stress test: A test of ligament laxity, where a passive force is exerted on a joint that, in the presence of ligamentous insufficiency, would cause the lateral joint space to open, e.g., lateral collateral ligament of the knee and radial collateral ligament of the elbow. See also: stress test Purpose: To assess the integrity of the MCL. Test Position: Supine. Performing the Test: The patient's leg should be relaxed for this test. The examiner should passively bend the affected leg to about 30 degrees of flexion. While palpating the medial joint line, the examiner should apply a valgus force to the patient's knee. This page includes the following topics and synonyms: Knee Valgus Stress Test, Knee Varus Stress Test. Importance of Test: The lateral collateral ligament is important for resisting varus force at the knee due to its attachments along the femur and fibular head. With the fibular nerve also located around the fibular head, any injury with a mechanism of a varus force to the knee could potentially stress the fibular nerve as well. Varus stress test elbow. Elbow examination stress tests. Valgus and varus stress test. The therapist applies a valgus stress at the knee while the ankle is stabilized in slight lateral rotation either with the hand or with the leg held between the examiners arm and trunk. A valgus stress test may be done to test the health of ligaments in the Define varus stress test. varus stress test synonyms, The results of physical examination were as follows: anterior drawer test, valgus stress test at 30 flexion, and McMurray findings were positive; posterolateral drawer test, and dial test were negative. Valgus and Varus Stress Test. Name. Purpose. Description. Sensitivity, Specificity. Validity, Reliability. Likelihood Ratio +/-Valgus Stress Test. An assessment for one-plane medial instability (gapping of the tibia away from the femur on the medial side). [1] Varus valgus stress test knee. Common Questions and Answers about Varus valgus stress test knee. stress-test. range of motion, Lachman and posterior drawer were negative with no effusion. no loose bodies and no significant synovitis within the suprapatellar pouch. The valgus and varus stress tests, anterior drawer test, pivot-shift test, and posterior drawer test had negative results, indicating an absence of ligamentous abnormalities. Double-Layered Lateral Meniscus in an 8-Year-Old Child: Report of a Rare Case

negative varus and valgus stress test top

Valgus & Varus Stress Test ( MTP & IP joints) - YouTube

Demonstration of the varus and valgus stress tests used in the examination of the knee joint. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators ... Valgus & Varus Stress Test Special Tests for the Knee: Valgus and Varus Stress Test - Duration: 5:53. Brent Brookbush 24,177 views. 5:53. Valgus Stress Test of the Knee⎟Medial Collateral Ligament - Duration: 2:01. Varus: Distal end towards midlineValgus: Distal end away from midline About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators ... Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP:📱 iPhone/iPad: https://goo.gl/eUuF7w🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT B... MCL and LCL integrity Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP:📱 iPhone/iPad: https://goo.gl/eUuF7w🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT B... This video demonstrates how to perform a varus stress test and a valgus stress test to diagnose lateral collateral ligament (LCL) and medial collateral ligam...

Varus Stress Test - The Student Physical Therapist

negative varus and valgus stress test

negative varus and valgus stress test - win

Clinical Case Study 1

negative varus and valgus stress test video

negative varus and valgus stress test top

Valgus & Varus Stress Test ( MTP & IP joints) - YouTube