50 • Non Medikamentosa
[14]
: o Penurunan berat badan pada OA
o PRICE protection, rest, ice, compression, elevation o Latihan terapeutik:
a. Hindari aktivitas dengan intensitas tinggi dan yang menahan beban seperti melompat, berputar, dan berlari
pada permukaan yang keras b. Quadricep strengthening khususnya untuk vastus medialis
obliques dengan cara straight leg raises, quad sets, and leg presses sesuai indikasi
c. Hamstring dan calf stretching d. Low impact aerobic seperti bersepeda, berenang, berjalan
e. Orthotics
o Operatif: • Bila konservatif tidak berhasil
• OA grade 3-4, sprainstrain grade 3 • Indikasi sosial
• Follow-up dilakukan dalam 6-12 minggu untuk yang weight bearing dan 3 minggu tanpa weight bearing
[14]
.
8. Edukasi
• Penjelasan Sebelum MRS rencana rawat, biaya, pengobatan, prosedur, masa dan tindakan pemulihan dan latihan, manajemen nyeri, risiko dan
komplikasi • Penjelasan mengenai risiko dan komplikasi selama perawatan
• Penjelasan mengenai faktor risiko dan pencegahan rekurensi • Penjelasan program pemulangan pasien Discharge Planning
51 • Penjelasan mengenai gejala dan apa yang harus dilakukan sebelum
dibawa ke RS
9. Prognosis
Ad vitam : ad bonam Ad sanam : tergantung derajat
Ad functionam : tergantung derajat
10. Kewenangan berdasar Tingkat Pelayanan Kesehatan
• Fasilitas Pelayanan Kesehatan Primer
- Skrining diagnostik
- Terapi pendahuluan dan merujuk ke dokter spesialis saraf
• PPK 2 RS tipe B dan C :
Talaksana medis dan intervensi invasif minimal sesuai dengan ketersediaan fasilitas
• PPK 3 RS tipe A : Talaksana medis komprehensif, intervensi invasif minimal, dan operatif
11. Kepustakaan
1. Hosny S, McClatchie W, Sofat N, Caroline B. H. 2012. Pain in Perspective, Chapter 8 : Knee Pain in Adults Adolescents, Diagnosis
and Treatment. http:cdn.intechopen.compdfs-wm40387.pdf
. Diakses 3 September 2016.
2. Calmbach WL, Hutchens M. 2003. Evaluation of Patients Presenting with Knee Pain: Part I History, Physical Examination, Radiographs, and
Laboratory Tests. American Family Physician Journal Vol. 68 no. 5. http:www.aafp.orgafp20030901p907.html. Diakses 2 September 2016.
3. South Norfolk Healthcare CIC. 2011. Proposed Knee Care Pathways For the Central Delivery Unit Board meeting on Tuesday, 20th December,
2011. http:snhcic.org.ukassetscms_page_media13Knee20Clinical20Path
way20v620SNH.pdf . Diakses 2 September 2016.
4. Calmbach WL, Hutchens M. 2003. Evaluation of Patients Presenting with Knee Pain: Part II Differential Diagnosis. American Family Physician
Journal Vol. 68 no. 5. http:www.aafp.orgafp20030901p917.html
. Diakses 2 Sepetember 2016.
5. Phillips J, Coetsee MF. 2007. Incidence of Non-traumatic Anterior Knee Pain Amon 11-17 year old. SAJSM Vol. 19 No. 2.
6. Helfenstein M Jr, Kuromoto J. 2010. Anserine Syndrome. Bras Journal of Rheumatology 50 3:313-27.
7. Differential Diagnosis
of Lesions
at The
Knee. http:www.orthopaedicmedicineonline.comdownloadspdfB9780702031
458000892_web.pdf . Diakses tanggal 4 September 2016.
52 8. Dixit S, Difiori JP, Burton M, Mines B. 2007. Management of
Patellofemoral Pain Syndrome. American Family Physician Journal Vol 75, No. 2.
9. Nijs J, Van Geel C, Van der auwera C, Van de Velde B. 2005. Diagnostic Value of Five Clinical Test in Patellofemoral Pain Syndrome. Journal of
Manual Therapy Vol. 11, p 69-77.
10. Thomee R, Augustsson J, Karlsson J. 1999. Patellofemoral Pain Syndrome : A review of Current Issues. Journal of Sports Medicine, Vol. 28.
11. Malliaras P, Cook J, Purdam C, Rio E. 2015. Patellar Tendinopathy : Clinical Diagnosis, Load Management, dan Advice for Challenging Case
Presentations. Journal of Orthopaedic and Sports Physical Therapy. Vol 45, No 11.
12. Stiell IG, Greenberg GH, Wells GA, McDowell I, Cwinn AA, Smith NA, Cacciotti TF, Sivilotti MLA. 1996. OTTAWA KNEE RULE for Knee Injury
Radiography, Prospective Validation of A Decision Rule For the Use of Radiography in Acute Knee Injuries. JAMA 1996; 275:611-615.
13. Tandeter HB, Shvaratzman P, Stevens MA. 1999. Acute Knee Injuries: Use of Decision Rules for Selective Radiograph Ordering. American
Family Physician
Journal Vol
60, No.
9, p
2599-2608. http:www.aafp.orgafp19991201p2599.html
. Diakses 4 September 2016.
14. Adult and Adolescent Knee Pain Guideline Unity. 2007. https:unityhealth.comdocsdefault-
sourcedocsclinicalguidelinesadultknee pain.pdf?sfvrsn=2 . Diakses 3
September 2016. 15. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan
J, Towheed T, Welch V, Welss G, Tugwell P. 2012. American College of Rheumatology 2012 : Recommendations for the Use of Nonpharmacologic
and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care and Research Journal, Vol 64, No. 4 pp 465-474.
16. MacMahon, PJ. Eustace, SJ. Kavanagh, EC. 2009. Injectable Corticosteroid and Local Anesthetic Preparations : A Review for
Radiologist. Radiology: Volume 252: Number 3, p 647-661 —September 2009.
17. Cardone DA, Tallia AE. 2003. Diagnostic and Therapeutic Injection of the Hip and Knee. American Family Physician Journal Vol. 67, No. 10.
http:www.aafp.orgafp20030515p2147.html. Diakses 4 September 2016.
53
Fibromialgia
M79.7 1. Pengertian
Fibromialgia adalah sindroma nyeri dengan manifestasi nyeri kronik muskuloskeletal non-artikular minimal selama 3 bulan yang tersebar luas
chronic widespread pain tanpa ditemukan kelainan pada sistem muskuloskeletal. Widespread pain merupakan nyeri yang meliputi nyeri aksial, nyeri pada sisi kiri
dan kanan tubuh, serta nyeri pada segmen atas dan bawah tubuh.
2. Anamnesis
