Ligaments and The Impairment Physical Exam

23 February 2012 / Impairment Physical Exam / Comments Off on Ligaments and The Impairment Physical Exam

Ligament:

A ligament is a soft, fibrous tissue structure that connects bone to bone to form a joint. A ligament differs from a tendon, which connects muscle to bone. Injury can occur when a ligament becomes stretched, partially torn, or completely disrupted. The injury can range from a minor strain to complete disruption of all fibrous tissue. Serious cases of injury may result in instability of the joint, significant bleeding, chronic pain, and swelling.

 

Most ligament injuries can be diagnosed by an X-ray or MRI scan and treated with conservative measures such as ice, rest, compression, and limited bracing. When a ligament overlies a joint, it may become difficult to determine if pain and symptoms are due to a ligament injury or an underlying joint injury. In certain instances such as a knee injury, the tendon and joint cartilage may be injured at the same time. Injuries that do not respond to conservative care may require additional imaging by an MRI and/or referral to an orthopedic specialist.

 

*A ligament connects bone to bone.
*Treatment is usually conservative. If the condition fails to improve, additional imaging by an orthopedic specialist may be indicated.

 

Review:
* Caution must be taken when diagnosing an injury that involves a ligament overlying a joint. Consideration must be given for a possible deep joint or cartilage structure injury.

 

Rating Comment: The AMA Guides Fifth Edition provides impairment rating for ligament instability in the wrist, chapter 16: Upper Extremities and in the knee, chapter 17: Lower Extremities. Additional impairment rating may also be assigned in some circumstances for ligament injuries that impair range of motion.

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