ACL rupture Flashcards
hx
21 yr old male footballer, caught foot, felt a pop 4 days ago, unable to play on, significant pain, v swollen, limping, unstable
look
antalgic gait
swelling of R knee joint
feel
patellar tap test for effusion [large effusion]
right knee joint line tenderness
ACL rupture a/w meniscus injury
active and passive movement
decreased ROM R knee due to swelling
special tests
cruciate ligament test
MCL & LCL
Meniscus exam
cruciate ligament test
ant drawer test pos
lachmans test pos
pivot shift test
MCL & LCL test
valgus and varus stress tests normal
Meniscus exam
McMurray’s test too painful to preform in acute setting
DDx
ACL rupture
PCL rupture
Cartilage/ meniscus injury
why is ACL rupture likely?
typica; hx traumatic twisting sports injury, pop, immediate swelling and pain, pos ant drawers test and lachmanns
why is PCL rupture unlikely?
much less frequent than ACL
usually fall or blow to flexed knee
pos drawers test if PCL
Why is cartilage/ meniscus injury unnlikely?
effusion at 24 hrs, locking rather than instability
Investigations
MRI knee
Xray knee
MRI knee
gold standard
can dx O’Donoghue’s triad ACL, MCL and medial meniscus injury
Xray knee
look for fracture
bony avulsion of ACL from tibia seen on x-ray in adolescents
