Exam 2 - Knee pain

Question 1

What mneumonic can be used to determine the cause of knee pain?

Answer 1

V: vascular (hemophilia, sickle cell anemia, Osgood, Schlatter)

I: inflammatory (arthritis, Lyme, cellulitis)

N: neoplasm (osteogenic carcinoma, giant cell tumors)

D: degeneration (osteoarthritis)

I: intoxication (gout, medications)

C: congenital disorders

A: autoimmune (rheumatic fever, lupus)

T: trauma (sprains, strains, fractures, hematomas, etc.)

E: endocrine (pseudo gout, hyperparathyroidism)

Question 2

What is a common knee injury that accounts for 30% of contact injuries?

Answer 2

ACL tear

Question 3

Physical presentation of ACL tear

Answer 3

• May not be able to walk
• Swelling
• Redness
• Malalignment

Question 4

What test can the provider use to determine whether there is an ACL tear or not? How is this performed?

Answer 4

Anterior drawer test

• Put fingers over head of tibia and thumb behind knee
• Pull forward
• If there is laxity, suspect ACL tear

Question 5

What imaging studies can be ordered to confirm an ACL tear?

Answer 5

MRI

Question 6

True/false: The meniscus can tear at the same time as an ACL tear

Answer 6

True

Question 7

Is the medial or lateral meniscus more likely to tear?

Answer 7

Medial

Question 8

What test can the provider perform to confirm a meniscus tear? How is this performed?

Answer 8

McMurray maneuver

• One hand on femur and other on lower leg
• Flex knee and twist while extension
• If there is a click or pop, suspect a meniscal tear

Question 9

What imaging could be ordered to confirm a meniscal tear?

Answer 9

MRI