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MSK clinical correlates > Disorders of the knee > Flashcards

Disorders of the knee Flashcards

1
Q

What is the main way a femoral shaft fracture occurs in children?

A

High velocity trauma

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2
Q

What is one of the main risks of a femoral shaft fracture?

A

The patient may go into hypovolaemic shock as 1,000- 1,500 ml of blood is lost

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3
Q

Where does a tibial plateau fracture occur?

A

On the articulating surface of the tibia with the knee

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4
Q

What kind of tibial plateau fracture is the most common?

A

Fracture of the LATERAL tibial condyle

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5
Q

What will a patient with a complete patellar fracture, distal to the insertion of the quadriceps be unable to do?

A

Unable to perform a straight leg raise

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6
Q

When looking at an X-ray of a patella, why must you be careful when diagnosing a patellar fracture?

A

A bipartite patella - present in 8% of the population Can be mistaken for a patellar fracture

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7
Q

What does subluxation of the patella mean?

A

A partial displacement of the patella

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8
Q

What is the most common direction for the patella to displace?

A

Laterally

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9
Q

How does a patella dislocation most commonly occur?

A

From a sudden change of direction playing sports

The femur internally rotates on a planted foot whilst the knee is flexed

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10
Q

Name some predisposing fractures for patellar dislocation

A
  • Generalised ligament laxity
  • Weak quadriceps muscles (especially the VMO)
  • Shallow trochlear groove with a flat lateral lip
  • Long patellar ligament
  • Previous dislocation
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11
Q

What is the most common kind of knee injury?

A

A meniscal tear

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12
Q

What kind of symptoms might a patient report if they had a meniscal injury?

A
  • Intermittent pain localised to the joint line
  • Knee may ‘click’, ‘latch’ or ‘lock’
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13
Q

Which ligament is at risk in acute valVus strain?

A

The Medial Collateral Ligament

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14
Q

Which ligament is at risk in acute vaRus strain?

A

The Lateral Collateral Ligament

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15
Q

What force does the lateral collateral ligament resist?

A

Valgus force

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16
Q

What force foes the medial collateral ligament resist?

A

Varus force

17
Q

Which collateral ligament is injured more commonly and why?

A

The MCL

It has a broader attachment and is attached to the collateral ligament which makes it more rigid, therefore easier to damage

18
Q

Which collateral ligament has a higher chance of causing knee instability?

A

The LCL

19
Q

What 3 things are injured in the Unhappy Triad (Blown Knee)?

A
  • ACL
  • MCL
  • Medial Meniscus
20
Q

Describe the kind of motion that usually causes the ACL to tear

A

Sudden deceleration, hyperextension or rotational injury - not usually injured in contact sports

21
Q

What is the most common mechanism of a PCL injury?

A

Dashboard injury - flexed knee colliding with dashboard in a RTA or falling on a fixed knee in sport

22
Q

Name the 2 tests that can be used to test for ACL/ PCL injury

A
  • Lachman’s test
  • Draw test
23
Q

Which ligaments need to be torn for the knee to dislocate?

A

At least 3 of either:

  • ACL
  • PCL
  • MCL
  • LCL
24
Q

Which artery is commonly injured if the knee dislocates?

A

Popliteal artery

25
Q

Define ‘acute’ and ‘delayed’ knee effusions

A

acute = <6 hours after injury

delayed = >6 hours after injury

26
Q

How can acute knee effusions be divided?

A
  • Haemarthrosis - blood in the joint (diagnostically an ACL injury unless proven otherwise)
  • Lipo-haemarthrosis - blood and fat in the joint (diagnostically a fracture unless proven otherwise as fat is released from bone marrow)
27
Q

What bursae is inflamed in Housemaid’s knee?

A

Pre patellar bursa

28
Q

What bursae is inflamed in Clergyman’s knee?

A

Infrapatellar bursa

29
Q

Name some causes of Suprapatellar bursitis

A
  • Osteoarthritis
  • RA
  • Infection
  • Gout or pseudo gout
  • Repetitive microtrauma (running on uneven surfaces)
30
Q

Describe how Baker’s cyst or semimembranous bursitis occurs

A

If the knee joint is inflamed, effusion can force itself out of a small opening between the knee joint into the semimembranous bursa

Causes a swelling on the back of the knee

31
Q

What is Osgood- Schlatter’s Disease?

A

Inflammation of site of insertion of the patellar ligament into the tibial tuberosity

32
Q

What group of people does Osgood-Schlatter’s most commonly occur in?

A

Sporty teenagers

Bilateral in most cases

33
Q

What symptoms might a patient describe in Osteoarthritis of the knee?

A
  • pain that comes and goes
  • pain precipitated by kneeling,bending, squatting etc
  • pain and stiffness that is worse after prolonged rest
34
Q

What is septic arthritis?

A

Invasion of the joint space by micro-organisms mainly staph. aureus

35
Q

What is the symptom triad of patients with septic arthritis?

A
  • Pain
  • Fever
  • Reduced range of motion
36
Q

Why do meniscal tears heal poorly?

A

Poor blood supply

37
Q

Why may patients with a torn meniscus present with a ‘locked knee’?

A

Large fragment of the meniscus can get caught in the knee mechanism of the knee

MSK clinical correlates (13 decks)

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