Acute Injuries to the Knee

Question 1

what symptoms would you want to clarify in the history?

Answer 1

> pop?
crack?
swelling (late, early)?

Question 2

what would you be looking for on examination of the knee?

Answer 2

Look
> scars
> swelling
> joint line irregularity

Feel
> effusion
> heat
> crepitus
> tissue lumps
> tenderness

Move
> range of movement
> ligament testing

Question 3

what are xrays good at picking up?

Answer 3

> fractures
> ligament avulsion
> loose bodies
> osteochondral defects
> degenerative joint disease

Question 4

what are ultrasounds good at picking up?

Answer 4

> cysts
tendon rupture
swellings
meniscal tears

Question 5

what are MRIs useful for?

Answer 5

> clinical conformation

Question 6

how would a collateral tear present?

Answer 6

> lateralised pain
bruising on one side
no or minimal effusion

Question 7

what is the mechanism of injury in a meniscal tear?

Answer 7

twisting movement on a loaded fixed knee

Question 8

what is the presentation of a meniscal injury?

Answer 8

> painful squelch
slow swelling
painful to weight bear
“locked knee”

Question 9

what are the options for management of a meniscal injury?

Answer 9

surgery

Question 10

what is the mechanism of injury in an anterior cruciate ligament injury?

Answer 10

forward momentum with leg fixed (maybe some rotation)

Question 11

how does anterior cruciate ligament injury present?

Answer 11

> often can weight bear
pop
quick swelling

Question 12

what are the indications for surgery to fix an anterior cruciate ligament tear?

Answer 12

> to prevent osteoarthritis
to go back to sport
to go back to work
to prevent further injury

Question 13

what surgical options are the for management of an osteochondral injury?

Answer 13

> debriment
reattachment of fragment
removal of loose bodies
ACI

Question 14

what non-surgical management is there for acute knee injuries?

Answer 14

> normal movement
> physio
> analgesia
> swelling reduction
> range of motion