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Sports Medicine > Injuries of the Lower Limb > Flashcards

Injuries of the Lower Limb Flashcards

1
Q

What are the three types of knee joint injuries?

A

Meniscal, ligament and articular cartilage injuries

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2
Q

What are the 6 mechanisms of injury for traumatic knee injuries?

A

Hyperflexion, hyperextension, varus (outwards), valgus (inwards), rotation and combination

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3
Q

What is the history of meniscal injuries?

A

Twisting injury in weight bearing, acute pain, catching, clicking, locking, giving way

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4
Q

What is the mechanism of injury for meniscal injuries?

A

Detachment of the meniscus, longitudinal/transverse rupture

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5
Q

What are the clinical findings of meniscal injuries?

A

Swelling, limited ROM, joint line tenderness, pain with squatting, positive McMurray’s test

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6
Q

What investigations are used for meniscal injuries?

A

MRI and ultrasound

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7
Q

What is the treatment for meniscal injuries?

A

Arthroscopy - tear is removed or repaired

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8
Q

What condition is a risk associated with meniscal injuries?

A

Osteoarthritis

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9
Q

What are four knee ligaments that can be injured?

A

Anterior cruciate, posterior cruciate, medial collateral, lateral collateral

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10
Q

What is the mechanism of injury for ACL injuries?

A

Twisting, hyperextension, weight bearing

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11
Q

What is the history of ACL injuries?

A

Injury mechanism, hear/feel snap/crack, pain, loss of function, swelling

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12
Q

What are the clinical findings of ACL injuries?

A

Specific tests - Lachman’s, pivot-shift

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13
Q

What investigations are used for ACL injuries?

A

X-ray, MRI, CT scan

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14
Q

What are the treatments and outcomes of ACL injuries?

A

Surgery vs. conservative; risk of osteoarthritis and recurrence

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15
Q

What is the mechanism of injury for PCL injuries?

A

Direct blow to anterior tibia, hyperextension

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16
Q

What is the history of PCL injuries?

A

Injury mechanism, pain, swelling, often presents late

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17
Q

What is considered in the examination of PCL injuries?

A

Swelling, posterior sag of tibia, posterior drawer test

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18
Q

What investigations are used for PCL injuries?

A

X-ray, MRI

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19
Q

What are the treatments for PCL injuries?

A

Usually conservative, surgery if unstable

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20
Q

What are the outcomes of PCL injuries?

A

Usually able to return to normal activity, always be aware of posterolateral corner injury

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21
Q

What is the mechanism of injury for valgus injuries?

A

Impact against the outside of the knee, pushing it inwards (lateral force)

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22
Q

What is the mechanism of injury for varus injuries?

A

Impact against the inside of the knee, pushing it outwards (medial force)

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23
Q

What is the mechanism of injury for medial collateral ligament (MCL) injuries?

A

Valgus stress

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24
Q

What is considered in the examination of MCL injuries?

A

Pain/tenderness medially, +/- swelling, gapping with valgus stress, grade 1/2/3

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25
Q

What investigations are used for MCL injuries?

A

X-ray, MRI

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26
Q

What are the treatments for MCL injuries?

A

Grade 1: Conservative, ROM brace

Grade 2: Often conservative, sometimes surgery

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27
Q

What is the mechanism of injury for lateral collateral ligament (LCL) injuries?

A

Varus stress

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28
Q

What is considered in the examination of LCL injuries?

A

Pain laterally, gapping laterally with varus stress, grade 1/2/3

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29
Q

What investigation is used for LCL injuries?

A

MRI

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30
Q

What are the treatments for LCL injuries?

A

Grade 1/2: Conservative

Grade 3: Surgery

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31
Q

The mechanism and clinical findings of articular cartilage injuries are similar to what other type of knee injury?

A

Meniscal

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32
Q

What is the treatment for articular cartilage injuries?

A

Arthroscopic debridement

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33
Q

What is a type of articular cartilage injury?

A

Osteochondritis dissecans

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34
Q

What is osteochondritis dissecans?

A

Death of articular cartilage and bone fragment, release of bone & articular cartilage into the joint

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35
Q

When does osteochondritis dissecans usually occur?

A

Adolescence

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36
Q

What are the symptoms of osteochondritis dissecans?

A

Pain, swelling, catching, locking

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37
Q

What is the anatomy of anterior knee pain?

A

Quadriceps mechanism, Q angle, patella mechanics

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38
Q

What are the causes of anterior knee pain?

A

Retropatella pain syndrome, patella tendinosis, traction apophysistis

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39
Q

What is the mechanism of injury for retropatella pain syndrome?

A

VMO, lateral structures, feet, exercise

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40
Q

What is the history of retropatella pain syndrome?

A

Pain with activity, prolonged sitting, pain up/down stairs

41
Q

What is considered in the examination of retropatella pain syndrome?

A

Laterally sitting patella, tight ITB/quads, weak VMO, excessive pronation of feet

42
Q

What is the treatment for retropatella pain syndrome?

A

VMO/quads strength, quads flexibility, physio, patella taping, podiatry review

43
Q

What is another name for patella tendinosis?

A

Jumper’s knee

44
Q

What are four types of traction apophysitis?

A

Osgood-Schlatter syndrome, Sinding-Larsen syndrome, bursitis, fat pad impingement

45
Q

What is Osgood-Schlatter syndrome?

A

Inflammation of the patellar tendon at the tibial tuberosity

46
Q

What is Sinding-Larsen syndrome?

A

Osteochondrosis of the patellar tendon

47
Q

What are two types of thigh injuries and what are they caused by?

A

Cork thighs (charleyhorse) and intra/extramuscular haematoma; caused by direct trauma

48
Q

What is the treatment for thigh injuries?

49
Q

What is a complication of thigh injuries?

A

Myositis ossificans - calcification in muscle tissue, develops weeks after injury, may last for months

50
Q

What is the treatment for myositis ossificans?

A

Rest, avoid aggravation, indomethacin (NSAID), surgery (rare)

51
Q

What are three types of leg pain?

A

Compartment syndrome, tibial stress fractures, periostitis (shin splints)

52
Q

What is compartment syndrome?

A

Increased pressure in muscle compartments of the leg, may be anterior, lateral, deep posterior or superficial posterior

53
Q

What is the history of compartment syndrome?

A

Pain with activity

54
Q

What is considered in the examination of compartment syndrome?

A

Tender, tight muscle compartments

55
Q

What investigation is used for compartment syndrome?

A

Compartment pressure test

56
Q

What is the treatment for compartment syndrome?

A

Conservative: Rest, ice, anti-inflammatories, massage, stretching
Surgery: Fasciotomy vs. fasciectomy

57
Q

What is the history of leg stress fractures?

A

Pain with activity, bony tenderness

58
Q

What is considered in the examination of leg stress fractures?

A

Tenderness over bone

59
Q

What investigations are used for leg stress fractures?

A

Bone scan, CT, MRI

60
Q

What is the treatment for leg stress fractures?

A

Conservative: Relative rest, ice, anti-inflammatories, massage

61
Q

What is the history of leg periostitis?

A

Pain with activity

62
Q

What is considered in the examination of leg periostitis?

A

Tender medial tibial border

63
Q

What investigations are used for leg periostitis?

A

Bone scan, x-ray, MRI

64
Q

What are the treatments for leg periostitis?

A

Conservative: Relative rest, ice, anti-inflammatories, massage, physio, podiatry review
Surgery (rare)

65
Q

True or false: an achilles tendon rupture is an acute event

66
Q

What is considered in the examination of an achilles tendon rupture?

A

Defect in tendon, lack of movement with squeeze test

67
Q

What investigations are used for an achilles tendon rupture?

A

Ultrasound, MRI

68
Q

What are the treatments for an achilles tendon rupture?

A

Surgery, conservative (walking boot)

69
Q

What is the history of achilles tendinopathy?

A

Pain over heel during activity

70
Q

What is considered in the examination of achilles tendinopathy?

A

Tender, swollen crepitus

71
Q

What investigations are used for achilles tendinopathy?

A

Ultrasound, MRI

72
Q

What are the treatments for achilles tendinopathy?

A

Conservative: Relative rest, ice, physio, eccentric strengthening program
Injection: sclerosants, collegenase inhibitor
Surgery: Remove degenerative tissue, calcification

73
Q

What is the history of lateral ligament foot injuries?

A

Inversion injury

74
Q

What is considered in the examination of lateral ligament foot injuries?

A

Pain, swelling, pain to bear weight

75
Q

What investigations are used for lateral ligament foot injuries?

A

X-ray, MRI

76
Q

What is the treatment for lateral ligament foot injuries?

A

Relative rest, ice, anti-inflammatories, physio

77
Q

What is emphasised during the rehabilitation of lateral ligament foot injuries?

A

ROM, strength and proprioception

78
Q

What complication is associated with lateral ligament foot injuries?

A

Risk of intra-articular injury

79
Q

What is the history of an ankle syndesmosis injury?

A

Eversion, radiation

80
Q

What is considered in the examination of an ankle syndesmosis injury?

A

Pain, swelling especially above the ankle, tender distal leg

81
Q

What investigations are used for an ankle syndesmosis injury?

A

X-ray including weight-bearing views, MRI

82
Q

What is an ankle syndesmosis injury also known as?

A

A high ankle sprain

83
Q

What is the treatment for an ankle syndesmosis injury?

A

Conservative: Air-cast brace/boot, non-weight bearing

Surgery

84
Q

What is the history of foot stress fractures?

A

Pain with activity

85
Q

What is considered in the examination of foot stress fractures?

A

Tender foot bones

86
Q

What investigations are used for foot stress fractures?

A

Bone scan, x-ray, CT, MRI

87
Q

What are the treatments for foot stress fractures?

A

Conservative: Relative rest, non-weight bearing, plaster cast, brace
Surgery

88
Q

What is the history of navicular stress fractures?

A

Pain with activity

89
Q

What is considered in the examination of navicular stress fractures?

A

Tenderness over navicular

90
Q

What investigations are used for navicular stress fractures?

A

Bone scan, CT, MRI

91
Q

What are the treatments for navicular stress fractures?

A

Conservative: Non weight-bearing immobilisation, walking cast
Surgery

92
Q

What tests are used for ankle fractures?

A

Percussion and compression tests

93
Q

What test is used for Achilles tendon integrity?

A

Thompson test

94
Q

What are four ankle stability tests?

A

Anterior drawer, talar tilt, Kleiger’s and Medial Subtalar Glide tests

95
Q

What tests are used for ACL injuries?

A

Drawer test at 90 degrees flexion, Lachman drawer test

96
Q

What test is used for PCL injuries?

A

Posterior sag test (Godfrey’s test)

97
Q

What tests are used for meniscal injuries?

A

McMurray’s, Apley’s compression and Apley’s distraction tests

98
Q

What tests are used for patella examination?

A

Patella grinding, compression and apprehension tests

Sports Medicine (15 decks)

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