Case Study: Knee Injury
This case study focuses on a male who suffered a knee injury form skiing, which in turn resulted in weakness in his foot. With the help of MR Neurography the doctor was able to accurately diagnose the patient and provide a successful outcome. The gentleman suffered an injury to his left knee while snow skiing. He fell onto his leg with an immediate disruption of the knee and instant onset of foot weakness. There was considerable swelling and discoloration from a hematoma in the knee. His knee had been in a brace. There had been some slight improvement in the ability to move the foot. He had weakness with dorsiflexion of the ankle and with moving his toes. He was evaluated by an orthopedic doctor and a repair of ligaments of the knee was recommended. However, there was concern of nerve involvement as well. Electrodiagnostic tests carried out demonstrated a connected, but abnormal peroneal but also tibial component function. When the patient went in for a physical examination, he was wearing a brace on his left knee with extensive swelling and a discoloration associated with hematoma in his knee and legs. Sensory testing for the left foot revealed irregular deficits mainly in deep peroneal with close to complete weakness for dorsiflexion and forefoot eversion, and some weakness for inversion also. Palpation and percussion proved for positive Tinel's at and just below the level of the fibular head, but not above the fibular head in the popliteal fossa. According to his examination and history, it was possible that the disruption of the knee associated with the injury had led to some ongoing entrapment of the peroneal nerve at the knee. There may have been a mechanical trauma or bruise to the nerves that will recover spontaneously. However, because there was a planned surgery for the knee ligaments and cartilage, it was logical at the time to inspect and evaluate the peroneal nerve from the level of...
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