Cibulka Michael T, Threlkeld-Watkins Julie
Jefferson County Rehabilitation and Sports Clinic, 1330 YMCA Dr, Suite 1200, Festus, MO 63028, USA.
Phys Ther. 2005 Nov;85(11):1201-7.
Patellofemoral joint problems are the most common overuse injury of the lower extremity, and altered femoral or hip rotation may play a role in patellofemoral pain. The purpose of this case report is to describe the evaluation of and intervention for a patient with asymmetrical hip rotation and patellofemoral pain.
The patient was a 15-year-old girl with an 8-month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 24%. Right hip medial (internal) rotation was less than left hip medial rotation, and manual muscle testing showed weakness of the right hip internal rotator and abductor muscles. The intervention was aimed at increasing right hip medial rotation, improving right hip muscle strength (eg, the muscle force exerted by a muscle or a group of muscles to overcome a resistance), and eliminating anterior right knee pain.
After 6 visits (14 days), passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her WOMAC score was 0%.
The patient had right patellofemoral pain and an uncommon pattern of asymmetrical hip rotation, with diminished hip medial rotation and excessive hip lateral (external) rotation on the right side. The patient's outcomes suggest that femoral or hip joint asymmetry may be related to patellofemoral joint pain.
髌股关节问题是下肢最常见的过度使用损伤，股骨或髋关节旋转异常可能在髌股关节疼痛中起作用。本病例报告的目的是描述对一名存在不对称髋关节旋转和髌股关节疼痛患者的评估及干预情况。
该患者为一名15岁女孩，右膝前部疼痛8个月，无已知外伤史。干预前，她的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分为24%。右髋内旋小于左髋内旋，手动肌力测试显示右髋内旋肌和外展肌无力。干预旨在增加右髋内旋，提高右髋肌肉力量（例如，一块肌肉或一组肌肉为克服阻力而施加的肌肉力量），并消除右膝前部疼痛。
经过6次就诊（14天）后，左右髋被动内旋对称，她的右髋内旋肌和外展肌评级为优加。她的WOMAC评分为0%。
该患者有右髌股关节疼痛和一种不常见的不对称髋关节旋转模式，右侧髋内旋减少且髋外旋过度。患者的结果表明，股骨或髋关节不对称可能与髌股关节疼痛有关。
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