Soft leg

Introduction The calf is soft, it doesn't work hard, and it walks a glimpse. This is called "soft legs." Patients with meniscus injury often have knee pain, softness, and leg and joint interlocking.

Cause

The external force factors that cause the meniscus to rupture include tearing external force and abrasive external force. The tearing external force occurs in the rotational motion of the knee joint in the semi-buckling state, the femoral traction side collateral ligament, and the ligament pulls the edge of the meniscus and tears. The abrasive external force mostly occurs in the lateral meniscus, especially the congenital discoid meniscus, which has a large position in the joint and is inflexible. It is easy to be worn by the joint surface for a long time and damage occurs.

After the meniscus injury, the collaterals are injured, qi stagnation and blood stasis, resulting in meridians, so early swelling, pain, and movement disorders may occur. After a few weeks, although the swelling subsided, but because of qi and blood stagnation, the blood is not glory, the bones are dying, so the muscles shrink and shrink, the knee joint is unstable, and the disease is soft and weak. During the flexion and extension of the knee joint, due to the front end or the rear end of the ruptured meniscus, it is embedded between the femur and the tibial articular surface, so joint interlocking and bounce can occur.

an examination

Related inspection

CT examination of the limbs and joints of the extremities

1. Most patients have a history of knee sprains.

2. When the knee joint is extended, the knee has a sound.

3. At the time of injury, there was a tearing and ringing sound in the knee joint, that is, severe pain, joint swelling, and flexion and extension dysfunction.

Knee joint pain is obvious when walking and going up and down the stairs. Some patients may have soft legs and locks on the knees.

4, the quadriceps atrophy can be found during the examination, there is tenderness in the knee joint space, the knee joint can not be overstretched or overflexed.

5, meniscus spring test (Mc's sign): the patient is supine, fully flexed hips and knees, the examiner holds the foot in one hand, one hand on the knee, first the inner leg of the calf, then outreach, and then straight out, then The calf is externally abducted, then the intestine is straightened, and if it is painful or flicker, it is positive. Most patients were positive.

6. Grinding test: The patient is in prone position, and the knee flexes 90°. The examiner presses hard on the ankle and rotates it. It is positive when there is pain in a certain position, and some cases can be positive.

Knee air angiography, iodine solution angiography or arthroscopy should be performed if necessary.

Differential diagnosis

Differential diagnosis of soft legs:

1. Loss of sensory inner side of the calf: The high-level injury of the femoral nerve injury is characterized by loss of sensory anterior medial and medial calf.

2, lower limb swelling and fatigue: lower limb swelling and fatigue is one of the symptoms of deep vein thrombosis.

3, lower limb weakness: lower limb weakness is caused by cervical spondylotic myelopathy, manifested as lower limb weakness, numbness, tightness, heavy lifting and other symptoms, gradually appearing limp, trembling, gait shaking, easy to fall, etc. .

Cervical spondylotic myelopathy is a type of cervical spondylosis. Cervical spondylosis can be roughly divided into four types: cervical cervical spondylosis, radiculous cervical spondylosis, vertebral artery type cervical spondylosis, and cervical spondylotic myelopathy. Cervical spondylosis, also known as cervical vertebra syndrome, is a general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, and cervical disc herniation. It is a disease based on degenerative pathological changes. Mainly due to long-term cervical vertebrae strain, bone hyperplasia, or disc herniation, ligament thickening, resulting in cervical spinal cord, nerve root or vertebral artery compression, a series of clinical syndromes of dysfunction. The manifestations of cervical disc degeneration and its secondary pathological changes, such as vertebral instability, loosening; nucleus protruding or prolapse; spur formation; ligament hypertrophy and secondary spinal stenosis, etc., stimulated or oppressed Adjacent nerve roots, spinal cord, vertebral artery, and cervical sympathetic nerves, and cause a variety of symptoms and signs of the syndrome.

4, the knee joint weakness: some patients with strong anterior cruciate ligament injury, the knee joint tear, then the knee joint weakness. The stability of the knee depends on four ligaments to maintain the two medial lateral ligaments and two cruciate ligaments. The medial and lateral ligaments are located inside and outside the knee joint; the cruciate ligament is inside the knee joint, which is called the anterior cruciate ligament and the posterior cruciate ligament. The anterior cruciate ligament originates from the medial aspect of the lateral femoral condyle and the medial intercondylar spine of the tibial plateau. Because these two ligaments appear in an intersecting state when they pass through the knee joint, they are called cruciate ligaments.

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