Glossary entry

Spanish term or phrase:

signo de escape

English translation:

patellar inhibition test / Zohler\'s sign

Added to glossary by Reuben Wright
Sep 1, 2023 15:40
10 mos ago
24 viewers *
Spanish term

signo de escape

Spanish to English Medical Medical (general)
Hola a tod@s,

This is a doctor's letter with information on the diagnosis of a knee injury.

"...se encontró datos clinicos de hiperpresión femoropatelar bilateral con signos de aprensión y escape positivos de predominio derecho, por lo que se solicita realizar resonancia magnetica nuclear de ambas rodillas se agrega reporte a esta carta.

I know that "signo de aprensión" refers to "positive for the [Patellar] Apprehension sign"
https://www.physio-pedia.com/Patellar_Apprehension_Sign

but I can't find "signo de escape" in relation to any knee tests. Is it fluid leaking into/out of the knee?

Is there a colleague specialized in medical who could help me out?

Gracias de antemano.
Change log

Sep 1, 2023 16:20: Reuben Wright changed "Field" from "Medical" to "Art/Literary"

Sep 2, 2023 16:48: Reuben Wright changed "Field" from "Art/Literary" to "Medical"

Discussion

Stuart and Aida Nelson Sep 2, 2023:
@Reuben Both signs are positive
Lisa Rosengard Sep 1, 2023:
This is not specialist but a possibility is a fluid secretion. Another possibility is a tear from within the knee joint area such as a pulled ligament or a torn muscle, with a potential swelling to the knee area.
Althea Draper Sep 1, 2023:
Ha! Miss Marple has nothing on me! 🕵️‍♀️
philgoddard Sep 1, 2023:
Wow! Althea's detective skills know no bounds...
Althea Draper Sep 1, 2023:
Links from Liz's previous answer These are the links (found by googling the exact text, google advanced search and with the help of Wayback machine). You should find that these work.
https://www.imbiomed.com.mx/articulo.php?id=22053
https://www.integrativehealthcare.org/mt/patellar-tests-for-...
https://web.archive.org/web/20160804161842/http://simbrazil....
https://sportinjuriesandwellnessottawa.blogspot.com/2009/12/...

Hope this helps.
Reuben Wright (asker) Sep 1, 2023:
Phil: Thank you for letting me know. I wasn't aware colleagues like you were non-paying members, and yes, that is the kind of expertise I'm looking for. I've changed the parameters. Unfortunately, the links for the previously chosen answer in the glossary don't work, so I was looking for something new.
philgoddard Sep 1, 2023:
Reuben: if you ban non-paying members like me from contributing, you're missing out on a lot of expertise.

The chosen answer last time looks convincing, but the answerer's first link doesn't work, so it's not easy to check.

Proposed translations

+1
8 hrs
Selected

patellar inhibition test / Zohler's sign

Signo de Escape
Se coloca al paciente en posición dorsal, con la pierna cruzada o en extensión y con un dedo el explorador se baja la rótula, al realizar dicha maniobra, el paciente con artrosis patelofemoral experimenta una sensación de dolor, por lo que contrae el cuádriceps para evitarlo.
https://www.studocu.com/es-mx/document/universidad-juarez-de...

También llamado signo de Zohler (o de Zohlen; no estoy seguro de cuál es la denominación correcta).

Este signo tiene bastante parecido con el signo de Clark (Clark's sign, Patellofemoral Grind Test), aunque se trata de dos signos diferentes.

Positive Zohler's and Clarke's tests were present, representing concomitant signs of grade I patellar chondromalacia.
[original castellano]
http://www.scielo.org.pe/scielo.php?pid=S2308-05312021000200...


Clarke's Sign is considered positive if the test causes retropatellar pain and the patient cannot hold or maintain a quadriceps contraction while the examiner is pressing down just proximal to the superior pole of the patella. This test can be performed at various degrees of flexion as well as full extension.
(...)
Zohler's Sign is positive in a large proportion of the normal population and is performed by pulling the patella distally and holding it while the patient performs a quadriceps contraction. Pain indicates a positive test.
https://www.google.com/url?sa=t&source=web&rct=j&opi=8997844...

Clarke's sign / patellar grind test
(...) presses down slightly proximal to the upper pole or base of the patella with the web of the hand (...) The patient is then asked to contract rhe quadriceps (...)
Pg 122
Zohler's sign
The patient lies supine with the knees extended. The examiner pulls the patella distally and holds it in this position. The patient is asked to contract the quadriceps
(...)
Pg 131
https://www.slideshare.net/JulieJaneTesta/special-tests-knee

Ver cómo realizar el Zohler's sign test, por ejemplo:
Zohler's sign
https://youtu.be/B7ENY0XAU-I?si=IRPgJ3SuT65zfIeb

https://youtu.be/hVAhadGZY9E?si=mfupCPtAP61Af-iJ

Ver aquí cómo realizar el Clarke's sign test:
https://youtu.be/pRqnODPqxFs?si=yIeOfZi0O9njdGNt

A todo esto y en cualquier caso, la denominación más común en inglés parece ser la de patellar inhibition test, y aunque como ya dicho a veces se confunda con el patellofemoral grinding test, son pruebas diferentes.

A positive grinding and positive Patellar Inhibition Test (PIT) were found to be risk factors for PFP at follow-up
https://pubmed.ncbi.nlm.nih.gov/30929582/

Ver aquí realización del PIT:
https://youtu.be/fqNyPs2VTlI?si=mkBXtECXshX343wB

Patellar Inhibition Test assesses for patellofemoral syndrome. With the knee extended, push the superior aspect of the patella inferiorly as the patient tightens the quadriceps muscle. Pain or crepitus is considered a positive test.
https://www.grepmed.com/images/16149/patellar-syndrome-patel...

Patellar inhibition test
https://www.google.com/amp/s/slideplayer.com/amp/13535320/

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Note added at 8 hrs (2023-09-02 00:36:41 GMT)
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Signo de Zohlen
(ver descripción e imagen)
https://www.tipsdesemiologia.com/rodilla://www.tipsdesemiolo...

Signo o test de Zolen
https://www.google.com/url?sa=t&source=web&rct=j&opi=8997844...


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Note added at 9 hrs (2023-09-02 00:45:51 GMT)
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Y en fin, y después de todo este rollo, al releerlo veo que me falta la referencia que relaciona el signo de escape con el de Zohler/Zohlen, y ahora resulta que no la encuentro por ninguna parte.

Voy a dormir algo y mañana le doy otra vuelta; a ver si después de todo este rollo... en fin. Saludos.


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Note added at 1 day 3 hrs (2023-09-02 19:03:31 GMT) Post-grading
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Por completar la información, el patellar inhibition test se describe en muchas ocasiones como equivalente al Clarke's sign test (patellar grinding test) y en otras se describe como una variación de este. En ocasiones se denomina también patello-femoral grinding/inhibition test. El Zohler's sign en cambio, sí suele diferenciarse del Clarke's sign, tanto en ámbito hispano como inglés, aunque en ocasiones también se describen como equivalentes.

En el fondo, lo que varía entre el Clarke (patellar grinding) y el Zohler (y generalmente el patellar inhibition test, aunque no siempre) es el procedimiento de inmovilización de la rótula, con la mano en el primer caso (Clarke) y con dos dedos en el segundo (Zohler). Supongo que de ahí la confusión, ya que en el fondo tratan de evaluar la misma respuesta (dolor con la contracción del cuádriceps con la rótula inmovilizada mediante presión en dirección distal).

Si queremos afinar, entiendo que el signo de escape debería describirse como Zohler's sign, asumiendo la equivalencia con este signo en castellano.

No obstante, y por complicar aún más las cosas, en alemán el "Zohlen-Zeichen" (literalmente signo de Zohlen) se realiza con la mano, exactamente igual que el Clarke's sign, y no con dos dedos, como habitualmente se procede cuando en ámbito hispano -o en ámbito inglés- nos referimos al signo de Zohler / Zohler's sign.
Peer comment(s):

agree Stuart and Aida Nelson : Encontré esta referencia, Chema: Durante la exploración física es de vital importancia la palpación de la patela y realizar el signo de cepillo( kholer( y escape(zholer) https://cdigital.uv.mx/bitstream/handle/1944/49988/Villanuev...
9 hrs
¡Muchas gracias, Aida!; esta es, de hecho, la misma referencia que había encontrado en la red (¡y la única que he podido encontrar!) pero la había traspapelado después de tirar del hilo. ¡Grax! ¡Saludos!
Something went wrong...
4 KudoZ points awarded for this answer. Comment: "Thanks Chema and Stuart and Aida Nelson for the references."

Reference comments

24 mins
Reference:

https://www.proz.com/kudoz/spanish-to-english/medical-general/6225244-signo-para-escape.html

This was accepted as an answer some years ago.

I've no idea - it's not my field
Note from asker:
Thank you for sharing. I saw this in the glossary but none of the links word.
Peer comments on this reference comment:

agree philgoddard
2 hrs
Something went wrong...
1 hr
Reference:

see

https://www.proz.com/kudoz/spanish-to-english/medical-genera...

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Note added at 17 часа (2023-09-02 09:31:58 GMT)
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https://www.google.com/search?q=patellar grind test signo de...

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Note added at 17 часа (2023-09-02 09:33:06 GMT)
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Patellar Grind Test
OrthoFixar
https://orthofixar.com › ... › Knee Special Tests
patellar grind test (Zohlen sign or Clarke sign) from orthofixar.com
by H Surgeon — Patellar Grind Test (Zohlen Sign or Clarke sign) is used to evaluate patellofemoral Pain Syndrome (chondromalacia patellae).

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Note added at 17 часа (2023-09-02 09:35:15 GMT)
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Management of Patellofemoral Pain Syndrome
American Academy of Family Physicians
https://www.aafp.org › pubs › afp › issues
by S DIXIT · 2007 · Cited by 498 — Patellar grind (or inhibition) test. While the patient is in the supine position with the knee extended, the examiner displaces the patella ...

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Note added at 17 часа (2023-09-02 09:35:47 GMT)
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https://www.proz.com/kudoz/german-to-english/medical-general...


so, my initial answer way back is correct

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Note added at 17 часа (2023-09-02 09:37:55 GMT)
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Test de Zohlen y su relación con el ángulo Q en población ...
Elsevier
https://www.elsevier.es › es-revista-...
El signo o test de Zohlen2 descrito en 1942 (y también mencionado como Patellar grind test o Clark sign entre otros) es parte habitual de nuestro examen ...
Something went wrong...
18 hrs
Reference:

Autoevaluación sobre síndrome patelofemoral

6. En la luxación patelofemoral recurrente, el regreso de la rótula al surco condíleo, generalmente ocasiona el signo de:

a) Escape
b) Cepillo
c) Aprensión
d) Ober
e) Rezago flexor

https://www.medigraphic.com/pdfs/orthotips/ot-2007/ot071n.pd...
Note from asker:
This is perfect. Thank you so much!
Peer comments on this reference comment:

neutral liz askew : how does this relate to "signo de escape"?
1 day 52 mins
The evaluation describes the signs involved in the diagnosis of a patellofemoral luxation among others 'el signo de escape'
Something went wrong...
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