Conditions of the Knee

Question 1

What investigations are indicated in patients with suspected knee conditions?

Answer 1

• x-ray
• can use an MRI to confirm diagnosis (especially for meniscal tears)
• CT scan and ultrasound are rarely used

Question 2

What is the most common cause of knee pain in the middle aged population? In adolescents and young adults (not counting trauma)?

Answer 2

• middle aged-elderly: osteoarthritis of the knee

- adolescents and young adults: chondromalacia patellae (anterior knee pain syndrome; idiopathic knee pain)

Question 3

How do we grade ligament injuries?

Answer 3

• I: no tear (a “strain injury”) (normal to mild laxity)
• II: partially torn (moderate laxity)
• III: completely torn (severe laxity)

Question 4

Anterior Cruciate Ligament Injuries

Answer 4

• due to a pivoting and valgus mechanism
• immediate pain and loss of function, improves with time
• (compare to meniscal injury: patient can continue to play and will feel it the next morning)

Question 5

Posterior Cruciate Ligament Injuries

Answer 5

• due to an anterior blow to the tibial tubercle, the common “dashboard” injury

Question 6

Which symptoms and signs suggest a tendon rupture?

Answer 6

• large hemarthrosis and an inability to do a straight leg raise
• patella ruptures require very large amounts of force
• quadriceps rupture can occur in elderly population when walking down the stairs

Question 7

Compare septic arthritis and infectious bursitis.

Answer 7

• septic arthritis: unable to weight bear, severe loss of R.O.M.
• infectious bursitis: usually still able to weight bear, moderate loss of R.O.M.

Question 8

How does iliotibial band syndrome usually present?

Answer 8

• lateral knee pain

- classically seen in distance runners

Question 9

What is Osgood-Schlatter syndrome?

Answer 9

• patellar tendinopathy in children (usually self-limiting)

- (most cases of tendinopathy are due to overuse of the joint)