By Desmond Oduffy
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Additional resources for Behcet's Disease (Inflammatory Disease and Therapy)
This can be detected by having the patient stand erect and then alternate the body weight from one leg to the other. One side may becompared with the other by inquiring about the presence or absence of pain and noting disability or muscle spasm on each side in these positions. When there is an unstable or painful hip or when the abductors are weak, a positive Trendelenburg test can be found. Normally, when standing on oneleg, the oppositeside ofthe pelvis will riseup. In the presence of an unstable or painful hip the opposite side of the pelvis drops down.
The thumbis placed medially and the fingers are located laterally in a position that might be used to grasp the quadriceps muscle. With the thumb and fingers exerting mild to moderate pressure, the examiner carefully palpates the underlying tissue as the handis movedgradually toward the knee joint in an attempt to locate the superior edgeof the synovial reflexion of the suprapatellar pouch. Note the consistency, nodularity, thickness, warmth, and tenderness of the skin, subcutaneous tissue, and muscles.
If fluid is present, it is often helpful if the examiner’s right hand is usedto push superiorly any synovial fluid from thelower reflections of the synovial cavity to distend the suprapatellar part further. Compressing the fluid in the extreme limits of the synovial reflexions over the region of the jointspace causes the edge of the synovial membrane to become palpable as a bulge. The ballotment of the patella may be possible when effusion is present, but to be successful this requires a relatively large amount of joint fluid and is not a sensitive method for the detection of a small quantity of fluid in the knee.