Knee

Question 1

MOI for Internal Derangement Meniscal

Answer 1

• Varus/valgus stress compressing meniscus
• Valgus/external rotation associated with MM
  vis versa.

Question 2

Classic Presentation Internal Derangement Meniscal

Answer 2

Following twisting knee
- No pain to severe pain; swelling and possibly catching; clicking.
- Patients may find it difficult to bend knee deeply.
- Locking can be present
 Effusion
 Sense of giving away
Older population -> degeneration -> refer

Question 3

Differential Diagnosis for Internal Derangement Meniscal

Answer 3

• MCL or LCL acute injury
• Medial tibial stress fracture
• Saphenous neuritis, CRPS
• iliotibial band friction syndrome
• Lateral patellofemoral subluxation syndrome

Question 4

Examination for Internal Derangement Meniscal

Answer 4

1. Joint line tenderness
2. Loss of full flexion/extension (squatting)
3. Quadriceps wasting
4. (+) Mcmurray Test (lateral/medial)
5. Apleys Test
6. Thessaly test
7. Valgus/varus stress (not the best)
8. Ege’s Test

Question 5

Osteochondral lesion (osteochondritis dissecans)
Clinical evaluation

Answer 5

• Tenderness on palpation over the involved condyle
• Decreased ROM
• Effusion
• Altered gait with externally rotated leg
• Wilson test

Question 6

Osteochondral lesion (osteochondritis dissecans)
clinical presentation

Answer 6

Typically Young athletic male, poorly localised knee pain or stiffness with or after activity.
- May have swelling,
- Clicking or catching can manifest at the late stage.

Question 7

Osteochondral lesion (osteochondritis dissecans) possible aetiology/causes

Answer 7

• trauma
• metabolic factors
• vascular causes/ischemia
• hereditary factors
• skeletal maturation
• anatomic variation
• genetic conditions

Question 8

Collateral and ACL orthopaedic tests

Answer 8

1. Varus/Valgus stress (0-30)
2. Drawer Test
3. Lever Sign (ACL)
4. Lachman test (ACL)
5. Pivot shift test (ACL)
6. Apley’s distraction test
7. Stroke test only tests effusion/good for rehabilition - not ACL test

Question 9

PCL and Posterolateral instability orthopaedic tests

Answer 9

1. Posterior instability (sag sign) PCL
2. Posterolateral drawer test
3. Reverse pivot-shift test
4. Dial Test
5. Quadriceps active test

Question 10

Patella Disorders Orthopaedic tests

Answer 10

1. Clark Test
2. Patellofemoral grind test
3. Patellar Tilt test
4. Patellar apprehnsion test
5. Retropatellar palpation
6. Single leg squat test

Question 11

Iliotibial Band Friction Syndrome - Orthopaedic tests

Answer 11

1. Noble Test
2. Modified Ober test
3. Ober test
4. Modified thomas test
5. One legged 30 knee flexion stance