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MSK 1 > Anterior Knee Pain > Flashcards

Anterior Knee Pain Flashcards

1
Q

Epidemiology of Anterior Knee Pain

  • PFPS remains most common orthopedic injury in active young _________ prevalence of 12-13%
  • PFPS is most common in ___________ and ___________
  • If patella dislocates, there is a _____% chance of reoccurrence
  • Patellar tendinopathy is common in sports requiring ________ and _________ (as many as 40 - 50% of volleyball, soccer, and basketball players)
A
  • PFPS remains most common orthopedic injury in active young FEMALES prevalence of 12-13%
  • PFPS is most common in ADOLESCENTS and YOUNG ADULTS
  • If patella dislocates, there is a 15% chance of reoccurrence
  • Patellar tendinopathy is common in sports requiring SPRINTING and JUMPING (as many as 40 - 50% of volleyball, soccer, and basketball players)
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2
Q

What are 3 static stabilizers of the knee?

A
  1. Patellar tendon
  2. Lateral retinaculum
  3. Medial retinaculum
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3
Q

What are 2 dynamic LOCAL stabilizers at the knee?

A
  1. Iliotibial band

2. Quadriceps

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4
Q

What are 5 dynamic REGIONAL stabilizers at the knee?

A
  1. Glute med
  2. Glute max
  3. Deep hip ER
  4. Lumbar stabilizers
  5. Ankle musculature
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5
Q

Active control

  • The VMO contracts simultaneously _______ or ________ vastus lateralis contraction
  • During patellofemoral pain syndromes, an inhibitory feedback mechanism, initiated by _______ or ________, can cause latent VMO contraction
A
  • The VMO contracts simultaneously WITH or BEFORE vastus lateralis contraction
  • During patellofemoral pain syndromes, an inhibitory feedback mechanism, initiated by PAIN or SWELLING, can cause latent VMO contraction
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6
Q

Patellofemoral Joint Biomechanics

Susceptible to injury:

  • near full extension b/c _________ (poor joint congruency)
  • near full flexion b/c increase in _________ force

PFJ reactive forces increase /c flexion of the knee from

  • ____x body weight during level walking
  • _____x body weight during step negotiation
  • ____x body weight /c squatting
A

Susceptible to injury:

  • near full extension b/c UNSTABLE (poor joint congruency)
  • near full flexion b/c increase in COMPRESSIVE force

PFJ reactive forces increase /c flexion of the knee from

  • 0.5x body weight during level walking
  • 3-4x body weight during step negotiation
  • 7-8x body weight /c squatting
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7
Q

Patellofemoral Joint Biomechanics

  • From knee extension, on average, the patella first shifts __________ 2.8 mm by 30 deg. of flexion, then back _________ 2mm by 90 deg. of flexion. Net patellar shift is negligible, generally about 3mm
  • Populations /c anterior knee pain have shown statically greater __________ shift of the patella compared /c controls
A
  • From knee extension, on average, the patella first shifts MEDIALLY 2.8 mm by 30 deg. of flexion, then back LATERALLY 2mm by 90 deg. of flexion. Net patellar shift is negligible, generally about 3mm
  • Populations /c anterior knee pain have shown statically greater LATERAL shift of the patella compared /c controls
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8
Q

Landing from a Jump

  • Knees over toes places more demand on _________ and increases ________ strain
  • Knees in line /c toes/ankles has a more even demand on _______ and _______ thus decreasing strain on ______
A
  • Knees over toes places more demand on QUADRICEPS and increases ACL strain
  • Knees in line /c toes/ankles has a more even demand on QUADS and HAMSTRINGS thus decreasing strain on ACL
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9
Q

Swelling / Edema = _________-articular

Effusion = ______-articular

A

Swelling / Edema = EXTRA-articular

Effusion = INTRA-articular

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10
Q
  • Genu valgum ________ the Q-angle and the subsequent force on the _______ patellar facet
  • Genu varum ________ the Q-angle and increases the force on the _______ patellar facet
A
  • Genu valgum INCREASES the Q-angle and the subsequent force on the LATERAL patellar facet
  • Genu varum DECREASES the Q-angle and increases the force on the MEDIAL patellar facet
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11
Q
  • Medial patellofemoral OA is more likely associated /c ______ alignment
  • Lateral patellofemoral OA is more likely associated /c _______ alignment
A
  • Medial patellofemoral OA is more likely associated /c VARUS alignment
  • Lateral patellofemoral OA is more likely associated /c VALGUS alignment
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12
Q

Tubercle Sulcus Angle

  • More _________ assessment of quadriceps vector
  • Relationship btw ____________ & _______ patellar pole
  • If tuberosity is > _____ deg lateral to inferior pole, predisposed to lateral patellar tracking
  • Measured /c knee in _____ deg. of flexion: Tibial tubercle to center of patella
A
  • More ACCURATE assessment of quadriceps vector
  • Relationship btw TIBIAL TUBEROSITY & INFERIOR patellar pole
  • If tuberosity is > 10 deg lateral to inferior pole, predisposed to lateral patellar tracking
  • Measured /c knee in 90 deg. of flexion: Tibial tubercle to center of patella
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13
Q
  • As the knee moves from flexion into extension, the patella normally glides _________ and tracks somewhat ________
  • in open chain, patellar pain is present at full _________
  • in closed chain, patellar pain is present at the ________ part of a squat
  • The relative _______ of the quads, hamstrings, IT band, and triceps sure should be determined
A
  • As the knee moves from flexion into extension, the patella normally glides SUPERIORLY and tracks somewhat LATERALLY
  • in open chain, patellar pain is present at full EXTENSION
  • in closed chain, patellar pain is present at the DEEPEST part of a squat
  • The relative FLEXIBILTY of the quads, hamstrings, IT band, and triceps sure should be determined
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14
Q

Patellar Tilt

  • Normal = lateral border raises/lifts ______ deg.
  • More than 15 deg. = _________ lateral tilt (predisposes to anterior knee pain, especially after long periods of sitting “theater knee”)
  • Less than 0 deg. = ___________ (tight lateral restraints, often in conjunction /c hypomobile medial glide)
A
  • Normal = lateral border raises/lifts 0 & 15 deg.
  • More than 15 deg. = HYPERMOBILE lateral tilt (predisposes to anterior knee pain, especially after long periods of sitting “theater knee”)
  • Less than 0 deg. = HYPOMOBILE (tight lateral restraints, often in conjunction /c hypomobile medial glide)
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15
Q
  • Hypomobile medial glide /c (+) tilt test = result tends to respond favorably to __________ treatment
  • Hypomobile medial glide may require surgical release of the _________ reticular structures to permit proper glide within the trochlea (especially /c h/o dislocation or subluxation)
A
  • Hypomobile medial glide /c (+) tilt test = result tends to respond favorably to CONSERVATIVE treatment
  • Hypomobile medial glide may require surgical release of the LATERAL reticular structures to permit proper glide within the trochlea (especially /c h/o dislocation or subluxation)
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16
Q

Patellofemoral Pain Syndrome (PFPS) Signs/Symptoms

  • Movement ___________ deficits (stairs, straight plane motion)
  • _______ / training errors (athletes; obese)
  • ________ impairments (hamstrings, gastroc, ITB)
  • Muscle __________ deficits (quads; hamstrings; hip ABD, ER, EXT weakness)
  • Localization of pain is ___
  • _________ and swelling
  • Aggravating activities = painful popping /c ______ running (plica/ITB), prolonged knee _______, Stair ________ / sit to stand)
A
  • Movement COORDINATION deficits (stairs, straight plane motion)
  • OVERUSE / training errors (athletes; obese)
  • MOBILTY impairments (hamstrings, gastroc, ITB)
  • Muscle PERFORMANCE deficits (quads; hamstrings; hip ABD, ER, EXT weakness)
  • Localization of pain is DIFFUSE
  • CREPITUS and swelling
  • Aggravating activities = painful popping /c HILL running (plica/ITB), prolonged knee FLEXION, Stair CLIMBING / sit to stand)
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17
Q

Patellofemoral Pain Syndrome Risk Factors

  • Females /c Unilateral PFPS show _________ hip ER, EXT, and ABD weakness
  • Sedentary females /c PFPS have weak hips (_______, __________, ______, & ______)
  • Greater hip ___________ observed in runners /c PFPS
  • Increased rear foot _________ at heel strike in those /c PFPS
A
  • Females /c Unilateral PFPS show GREATER hip ER, EXT, and ABD weakness
  • Sedentary females /c PFPS have weak hips (FLEX, EXT, ABD, & ER)
  • Greater hip ADDUCTION observed in runners /c PFPS
  • Increased rear foot EVERSION at heel strike in those /c PFPS
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18
Q

What is the patellofemoral diagnostic cluster (2 of 3 required)?

A
  1. Pain /c resisted knee extension
  2. Pain /c squatting
  3. Pain /c peripatellar palpation
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19
Q

Pathoanatomics of Anterior Knee Pain

  • _________ and ________ are most sensitive
  • _________, _______ surfaces, and ________ are less sensitive
  • Articular cartilage is _________; if there is thinning to subchondral bone, the potential exists for __________
A
  • FAT PAD and SYNOVIUM are most sensitive
  • MENISCUS, ARTICULAR surfaces, and LIGAMENTS are less sensitive
  • Articular cartilage is ANUERAL; if there is thinning to subchondral bone, the potential exists for NOCICEPTION
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20
Q

__________ sensitization occurs /c patellofemoral pain

- How do we treat this?

A

CENTRAL sensitization occurs /c patellofemoral pain

- TX: education, and tolerable activities w/o an increase in pain (aka graded exercise)

21
Q

What are the 4 classifications of patellofemoral pain?

A
  1. Overuse/overload w/o other impairment
  2. Muscle performance deficits
  3. Movement coordination deficits
  4. Mobility impairments
22
Q

PFPS — Overuse/overload w/o other impairment

  • history suggesting an increase in magnitude and/or frequency of PFJ _______ at rate that surpasses the ability of his or her PFJ tissues to recover
  • Treatment = ________ loading the joint
A
  • history suggesting an increase in magnitude and/or frequency of PFJ LOADING at rate that surpasses the ability of his or her PFJ tissues to recover
  • Treatment = BACK OFF loading the joint
23
Q

PFPS — Muscle performance deficits

  • Tx = May respond favorably to ______ and ______ resistance exercises (strengthen muscles)
  • Pt presents /c muscle performance deficits in the _____ and _________
A
  • Tx = May respond favorably to HIP and KNEE resistance exercises (strengthen muscles)
  • Pt presents /c muscle performance deficits in the HIP and QUADRICEPS
24
Q

PFPS — Movement Coordination Deficits

  • Tx = may respond favorably to _______ retraining and movement _________ interventions; work on the ______ movements you are concerned about
  • Pt presents /c excessive or poorly controlled knee ______ during a dynamic test, but not necessarily d/t __________ of the LE musculature
A
  • Tx = may respond favorably to GAIT retraining and movement RE-EDUCATION interventions; work on the EXACT movements you are concerned about
  • Pt presents /c excessive or poorly controlled knee VALGUS during a dynamic test, but not necessarily d/t WEAKNESS of the LE musculature
25
Q

PFPS — Mobility Impairments
- Pt presents /c _______ than normal foot mobility and/or flexibility deficits of _____ or more of the following structures: hamstrings, quadriceps, gastrocnemius, soles, lateral retinaculum, or iliotibal band

A
  • Pt presents /c HIGHER than normal foot mobility and/or flexibility deficits of 1 or more of the following structures: hamstrings, quadriceps, gastrocnemius, soles, lateral retinaculum, or iliotibal band
26
Q

PFPS

  • Patellar taping should provide _____% pain relieve /c activity
  • taping doesn’t change patellar ________ much, but it does increase ______ activity
A
  • Patellar taping should provide 50% pain relieve /c activity
  • taping doesn’t change patellar POSITION much, but it does increase VMO activity
27
Q

Jumper’s Knee: Patellar Tendinopathy

  • __________ and/or _________ of patellar tendon d/t repetitive activity/trauma
  • Pain at _______ pole of patella
  • Pain at _______ pole of patella = quadriceps tendinopathy
  • Resisted knee extension may increase pain to the point that _______ is inhibited
  • Tender on palpation of the _______ tendon
  • H/o repetitive ______, ________, or overuse (_______ based activities)
  • Excessive foot ________ and running _______ can exacerbate symptoms
  • Population = ______ y.o. (gender = ______ > ________)
A
  • INFLAMMATION and/or DEGENERATION of patellar tendon d/t repetitive activity/trauma
  • Pain at INFERIOR pole of patella
  • Pain at SUPERIOR pole of patella = quadriceps tendinopathy
  • Resisted knee extension may increase pain to the point that STRENGTH is inhibited
  • Tender on palpation of the PATELLAR tendon
  • H/o repetitive JUMPING, RUNNING, or overuse (ECCENTRIC based activities)
  • Excessive foot PRONATION and running HILLS can exacerbate symptoms
  • Population = 16 - 40 y.o. (gender = MALES > FEMALES)
28
Q

Tendinopathy =
Tendinosis =
Tendinitis =

A 
Tendinopathy = general pathology of the tendon
Tendinosis = degeneration of the tendon
Tendinitis = inflammation of the tendon
29
Q

Jumper’s Knee (Patellar Tendinopathy)

- What is Bassett Sign?

A

Tenderness to palpation of patellar tendon /c knee at full extension (when tendon is relaxed). Non-tender to palpation of patellar tendon /c knee in full flexion (when tendon is taut)

30
Q

What to examine /c Jumper’s Knee (Patellar tendinoapthy):

  • _________ atrophy
  • _________ and _______ tightness
  • Knee _______ is rare
  • Ligaments usually _________
  • Biomechanical components: excessive foot __________, patellar _____ mobility, patellar _______, tibial/femoral ________
A
  • QUAD atrophy
  • QUAD and HAMSTRING tightness
  • Knee EFFUSION is rare
  • Ligaments usually STABLE
  • Biomechanical components: excessive foot PRONATION, patellar HYPO/HYPER mobility, patellar ALTA/BAJA, tibial/femoral ROTATION
31
Q

Pathophysiology of Tendinopathies:

  • ___________ collagen fibers
  • Increased ________ & ________ nerves
  • More immature type _______ collagen (as opposed to mature type _____ collagen)
  • Increased ______ content (less _________)
  • Areas of: cell death (__________), Fibroblast reaction (____________)
A
  • DISORGANIZED collagen fibers
  • Increased VASCULARITY & SENSORY nerves
  • More immature type III collagen (as opposed to mature type I collagen)
  • Increased WATER content (less COLLAGEN)
  • Areas of: cell death (HYPOCELLUARITY), Fibroblast reaction (HYPERCELLULARITY)
32
Q

Evaluation of Patellar Tendinopathy:

  • Onset?
  • Pain?
  • Mechanism?
  • Predisposing factors?
  • Inspection?
  • Palpation?
  • AROM?
  • PROM?
  • RROM/MMT?
A
  • Onset = insidious
  • Pain = inferior patellar poles, tibial tuberosity
  • Mechanism = knee extension, ECC quad contraction, valgus force
  • Predisposing factors = knee extension, contusion on patella
  • Inspection = patellar tendon and inferior pole inflammation possible
  • Palpation = patellar tendon
  • AROM = pain /c active knee extension
  • PROM = pain at end of knee flexion
  • RROM/MMT = pain t/o knee extension
33
Q

Stage 1 Intervention for Patellar Tendinopathy = ___________ Loading

  • Indicated when more than _________ pain during isometric exercise
  • Dosage = ____ reps of _____ seconds; ____x/day, progress to _____% MVIC as pain allows
A

Stage 1 Intervention for Patellar Tendinopathy = ISOMETRIC Loading

  • Indicated when more than MINIMAL pain during isometric exercise
  • Dosage = 5 reps of 45 seconds; 2-3X/day, progress to 70% MVIC as pain allows
34
Q

Stage 2 Intervention for Patellar Tendinopathy = ___________ Loading

  • Indicated when: ________ pain during isotonic exercise
  • _____ sets at a load of ___ RM, progressing to a load of ___ RM, every second day, _____ load
A

Stage 2 Intervention for Patellar Tendinopathy = ISOTONIC Loading

  • Indicated when: MINIMAL pain during isotonic exercise
  • 3-4 sets at a load of 15 RM, progressing to a load of 6 RM, every second day, FATIGUING load
35
Q

Stage 3 Intervention for Patellar Tendinopathy = ___________ Loading

  • Indicated when: Adequate strength and consistent /c other side and load tolerance /c initial-level energy storage exercise (i.e. ______ pain during exercise and pain on load tests returning to baseline within _____ hours)
  • Progressively develop ________ and then _________ of relevant energy-storage exercise to replicate demands of sport
A

Stage 3 Intervention for Patellar Tendinopathy = ENERGY-STORING Loading

  • Indicated when: Adequate strength and consistent /c other side and load tolerance /c initial-level energy storage exercise (i.e. MINIMAL pain during exercise and pain on load tests returning to baseline within 24 hours)
  • Progressively develop VOLUME and then INTENSITY of relevant energy-storage exercise to replicate demands of sport
36
Q

Stage 4 Intervention for Patellar Tendinopathy = ___________

  • Indication: Load tolerance to energy-storage exercise progression that _______ demands of training
  • Progressively add training drills, then ________, when tolerant to full training
A

Stage 4 Intervention for Patellar Tendinopathy = RETURN TO SPORT

  • Indication: Load tolerance to energy-storage exercise progression that REPLICATES demands of training
  • Progressively add training drills, then COMPETITION, when tolerant to full training
37
Q

Acute Patellar Dislocation

  • Patient often reports “___________”
  • Tender __________ retinaculum (torn)
  • Usually a tense effusion (____________)
  • May have ____________ fracture of patella or ________ position of patella
  • MOI: ________ on plantar foot or _______ directly on knee
  • occurs more ________ each time
A
  • Patient often reports “KNEE SHIFTED”
  • Tender MEDIAL retinaculum (torn)
  • Usually a tense effusion (HEMARTHROSIS)
  • May have OSTEOCHONDRAL fracture of patella or SUBLUXED position of patella
  • MOI: TWISTING on plantar foot or FALL directly on knee
  • occurs more EASILY each time
38
Q

Evaluation of Dislocating of Subluxating Patella

  • AROM: pain first _____ flexion, terminal ext
  • PROM: pain as knee enters _______
  • RROM: decreased strength during ______
  • Ligamentous tests = _________ lateral glide & patellar tilt
  • Special tests = ___________________
  • may progress to ________ fractures to lateral femoral condyle or patella
A
  • AROM: pain first 30 flexion, terminal ext
  • PROM: pain as knee enters FLEXION
  • RROM: decreased strength during FLEXION
  • Ligamentous tests = HYPERMOBILE lateral glide & patellar tilt
  • Special tests = PATELLAR APPREHENSION
  • may progress to OSTEOCHONDRAL fractures to lateral femoral condyle or patella
39
Q

Osgood-Schlatter Disease

  • Active, skeletally _________ athlete (< 16 - 18 y.o.)
  • Tender _________
  • Prominent _____________
  • Partial ________ of tibial tubercle
  • More common in ________ (gender)
  • Local __________ and _________ (pain is aggravated by direct pressure of tibial prominence & jumping)
  • Condition occurs at a time when _________ demands are made on a still ________ skeleton
  • Gets better as ________ close
A
  • Active, skeletally IMMATURE athlete (< 16 - 18 y.o.)
  • Tender TIBIAL TUBERCLE
  • Prominent TIBIAL TUBERCLE
  • Partial AVULSION of tibial tubercle
  • More common in MALES (gender)
  • Local SWELLING and TENDERNESS (pain is aggravated by direct pressure of tibial prominence & jumping)
  • Condition occurs at a time when INCREASING demands are made on a still IMMATURE skeleton
  • Gets better as GROWTH PLATES close
40
Q

Sinding-Larsen-Johansson

  • Pain at the attachment of the patellar tendon into the ______ patellar pole or less commonly at the quadriceps tendon attachment at the _________ pole of the patella
  • Lightly _______, ________, and tender bump
  • Gender = _______ > _______
  • Age = ______ y.o.
  • May have palpable bump at ________ pole of patella
A
  • Pain at the attachment of the patellar tendon into the INFERIOR patellar pole or less commonly at the quadriceps tendon attachment at the PROXIMAL pole of the patella
  • Lightly SWOLLEN, WARM, and tender bump
  • Gender = MALE > FEMALE
  • Age = 10 - 14 y.o.
  • May have palpable bump at INFERIOR pole of patella
41
Q

Patellar Tendon Rupture

  • _______ tendon overloads the patellar tendon, resulting in the rupture of its mid-substance or avulsion from patella or tibial tuberosity
  • MOI: ____________ or powerful knee _______ from a weight bearing position
  • Gross deformity is observed (patella moves _______, exposing condyles)
  • During palpation, a depression is noted in the __________ region
  • Unable to perform a ________________ on the affected side
  • Patient is still able to contract ________
A
  • QUADRICEPS tendon overloads the patellar tendon, resulting in the rupture of its mid-substance or avulsion from patella or tibial tuberosity
  • MOI: HYPERFLEXION or powerful knee EXTENSION from a weight bearing position
  • Gross deformity is observed (patella moves PROXIMAL, exposing condyles)
  • During palpation, a depression is noted in the INFRAPATELLAR region
  • Unable to perform a STRAIGHT LEG RAISE on the affected side
  • Patient is still able to contract QUAD
42
Q

Evaluation of Patellar Rupture

  • Onset?
  • Pain?
  • Mechanism?
  • Predisposing?
  • Inspection?
  • Palpation?
  • AROM?
  • Ligamentous Test?
  • Neurological Test?
  • Population?
A
  • Onset = acute
  • Pain = patellar tendon, quads, patella
  • Mechanism = dynamic overload, ECC contraction of quads
  • Predisposing = patellar tendon inflammation, corticosteroid injections
  • Inspection = deformity, patella high on femur
  • Palpation = palpable defect in patellar tendon
  • AROM = able to contract quad, but unable to do knee extension
  • Ligamentous Test = suspect possible damage to knee ligaments
  • Neurological Test = peroneal or tibial nerve
  • Population = men younger than 40 y.o.
43
Q

Patellar Bursitis (“housemaids knee”)

  • single traumatic force, related _____ intensity blows, _________, or infection /c _________
  • The superficial __________ bursa and the subcutaneous ____________ bursa are the most often injured secondary to direct trauma
A
  • single traumatic force, related LOW intensity blows, OVERUSE, or infection /c STAPHYLOCOCCUS
  • The superficial PREPATELLAR bursa and the subcutaneous INFRAPATELLAR bursa are the most often injured secondary to direct trauma
44
Q

Evaluation of Prepatellar Bursitis

  • Onset?
  • Pain?
  • Mechanism?
  • Predisposing?
  • Inspection?
  • Palpation?
  • AROM?
  • PROM?
  • RROM?
A
  • Onset = acute or chronic
  • Pain = localized to superficial bursa
  • Mechanism = direct trauma or overuse
  • Predisposing = patellar tendinitis
  • Inspection = localized swelling
  • Palpation = pain infra patellar fat pad, bursa
  • AROM = pain t/o entire ROM
  • PROM = pain specific point ROM
  • RROM = decreased strength and pain
45
Q

Synovial Plica

  • A fold of the ________ membrane that projects into the joint cavity
  • This _________ abnormality is a remnant of folds formed during the embryologic stage of development
  • Onset of symptoms occurs most commonly in ___________
  • Alters the biomechanics of patellar _________ mechanism
A
  • A fold of the FIBROUS membrane that projects into the joint cavity
  • This CONGENITAL abnormality is a remnant of folds formed during the embryologic stage of development
  • Onset of symptoms occurs most commonly in ADOLESCENTS
  • Alters the biomechanics of patellar GLIDING mechanism
46
Q

Evaluation of Synovial Plica

  • Onset?
  • Pain?
  • Mechanism?
  • Predisposing?
  • Inspection?
  • Palpation?
  • AROM?
  • PROM?
  • RROM?
  • Ligamentous tests?
  • Differenital Dx?
A
  • Onset = insidious
  • Pain = anterior portion of knee, clicking, popping, worse in morning
  • Mechanism = friction of place rubbing against femoral condyle
  • Predisposing = congenital, decreases /c age
  • Inspection = no visual findings
  • Palpation = thickened bandlike, tender on anteromedial capsule
  • AROM =pain as place crosses femoral condyles, clicking, popping
  • PROM = clicking when knee is flexed and extended
  • RROM = same as AROM
  • Ligamentous tests = lateral patellar glide is decreased
  • Differenital Dx = meniscal tear, subliming patella, chondromalacia
47
Q

Patellar Fracture

  • Risk of patellar fracture may be increased following ________________ autograft anterior cruciate ligament reconstruction
  • Active knee __________ (if possible) and passive knee _________ produce severe pain
A
  • Risk of patellar fracture may be increased following BONE-PATELLAR TENDON-BONE autograft anterior cruciate ligament reconstruction
  • Active knee EXTENSION (if possible) and passive knee FLEXION produce severe pain
48
Q

Chondromalacia patellae

  • ___________ cartilage pathology of PFJ
  • Aggravating factors = increased PFJ _______
  • Type I: Patellar surface ________; softening; _________ formation
  • Type II: __________ in surface but no large cavities
  • Type III: Fibrillation; bone may be _________; “_________” appearance
  • Type IV: ________ formation; underlying _______ involvement
A
  • ARTICULAR cartilage pathology of PFJ
  • Aggravating factors = increased PFJ FORCES
  • Type I: Patellar surface INTACT; softening; SWELLING/BLISTER formation
  • Type II: CRACKS/FISSURING in surface but no large cavities
  • Type III: Fibrillation; bone may be EXPOSED; “CRAB MEAT” appearance
  • Type IV: CRATER formation; underlying BONE involvement

MSK 1 (4 decks)

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