History
- Young
- Traumatic twisting injury
- Could be minor twist
- Possible direct trauma
- May have history of previous episodes
- Swelling
- Relocation? Spontaneous or A&E assisted?
Signs
- Limp
- May be swelling
- Loss of range of movement
- Patella apprehension test positive
- Quads inhibition
- Pain around patella on palpation
- Confirm SLR – is extensor mechanism intact?
Secondary care referral
- Urgent referral to Trauma service if traumatic, first time dislocation with gross swelling
- For recurrent dislocations IF have completed extensive rehabilitation
Primary care investigations
- X-Ray AP, lateral and skyline view – Urgent if high index of suspicion
Primary care treatment
- Analgesia
- PRICE (Protection, Rest, Ice, Compression, Elevation)
- Physiotherapy
- Patella stabilising brace – suggest patient purchase
