Knee

Question 1

ACL injury commonly also has what injury associated?

Answer 1

meniscal tear

Question 2

Positive valgus stress test

Answer 2

MCL injury

Question 3

Positive varus test

Answer 3

LCL injury

Question 4

function of meniscus

Answer 4

shock absorber between femur and tibia

Question 5

After knee injury, patient unable to squat and waddle. Positive thessaly, mcmurray, and apley compression tests. dx?

Answer 5

meniscal injury

Question 6

what injury would be most common in athlete that TWISTS and PIVOTS a lot?- football, bball, soccer

Answer 6

meniscal injury

Question 7

acute onset of posterior thigh pain, antalgic gait, limited hip flexion and extension dx?

Answer 7

hamstring injury- MRI or US

Question 8

“tennis leg”=

Answer 8

medial gastrocnemius tear- acute rupture of medial head of gastrocnemius

Question 9

Patient presents with tearing/pulling sensation in medial superior calf, pain, swelling, tenderness. Foot is in constant plantar flexion to avoid pain. dx? tx?

Answer 9

medial gastrocnemius tear. RICE, analgesics, keep foot in maximal tolerable dorsiflexion

Question 10

most knee ligament/meniscal injuries treated by:

Answer 10

RICE and analgesics

Question 11

patellar fracture direct vs. indirect force

Answer 11

direct- comminuted, stellate fx. indirect force- transverse fx

Question 12

complication to worry about in proximal tibial fracture

Answer 12

compartment syndrome

Question 13

how would tibiofemoral dislocation present

Answer 13

obvious! gross instability- hyperextension of the knee more than 30 degrees

Question 14

tx for tibiofemoral dislocation and complications

Answer 14

SURGICAL EMERGENCY!. limb threatning. complications- compartment syndrome, peroneal n. injury, DVT, instability

Question 15

Runner presents with tenderness along anterior medial crest of tibila in the middle or distal one third of leg. dx and tx?

Answer 15

Xray to r/o anterior tibial stress fracture. medial tibial stress syndrome is dx. tx- RICE, rest

Question 16

how to differentiate between anterior tibial stress fracture and medial tibial stress syndrome?

Answer 16

MRI. Xray is positive in less than 50% of cases in anterior tibial stress fracture

Question 17

“dreaded anterior black line”

Answer 17

anterior tibial stress fracture

Question 18

2 most commonly involved knee bursa

Answer 18

pes anserine and prepatellar bursa

Question 19

How is gait and ROM affected in knee bursitis?

Answer 19

they’re normal- remember it is extra-articular

Question 20

tx/dx in knee bursitis

Answer 20

aspiration if prepatellar bursitis to r/o infection (septic bursitis) and crystals (gout). NSAIDS, ice, activity modification

Question 21

Patient presents with anterior knee pain that is worse at end of exercise. swelling, crepitus, hyperflexion causes pain. Xrays negative. US shows tears.

Answer 21

patellar/quadriceps tendinitis

Question 22

jumpers knee aka

Answer 22

patellar/quadriceps tindenitis

Question 23

runners knee aka

Answer 23

iliotibial band syndrome

Question 24

Runner and cyclist that has anterolateral knee pain that worsens with activity. Pain free at rest. Upon PE, there is tenderness over lateral femoral epicondyle. Positive noble’s test and ober’s test. dx?

Answer 24

Iliotibial band syndrome

Question 25

Iliotibial band runs from..

Answer 25

ilium to the anteriolateral aspect of the tibia

Question 26

“movie theater” sign a/w

Answer 26

patellofemoral pain syndrome

Question 27

Anterior knee pain worse with with squatting, prologned sitting, stairs. Xray r/o arthritis. suspect

Answer 27

patellofemoral pain syndrome- common. r/o overuse

Question 28

Retropatellar pain with malalignment, pain, popping, deformity. Knee tender to palpation, decreased ROM, positive apprehension sign, high riding patella. Positive J sign, patella moves laterally. dx?

Answer 28

patellofemoral instability

Question 29

miserable malalignment syndrome, patellar dislocation/subluxation aka

Answer 29

patellofemoral instability

Question 30

valgus vs. varus deformity

Answer 30

valgus- knock knee. MCL stability. Varus- bow legged- LCL stability

Question 31

ballottement sign indicates

Answer 31

knee effusion

Question 32

Ottawa knee rules for ordering xray (5)

Answer 32

greater than 55, isolated tenderness of patella with no other bony tenderness, tenderness at head of fibula, inability to flex knee to 90 degrees, and inability to bear weight

Question 33

folds of synovium in the knee that get thickened, fibrotic, or avascular

Answer 33

plica syndrome

Question 34

Activity related anterior and medial knee pain, hisotry of trauma/overuse, a/w popping sensation with knee FLEXION, tight hams/quads. Positive knee extension test. positive medial patellar plica test. Xray negative. dx?

Answer 34

plica syndrome- surgically confirmed via arthroscopy

Question 35

when would you consider surgery if patient with plica syndrome

Answer 35

NSAIDS, ice, stretching/strengthening for 1 year but still not better

Question 36

enlargement of gastrocnemius-semimembranosus bursa/ aka BAKERS cyst

Answer 36

popliteal cyst

Question 37

Mass visible on posterior knee. Pain/difficulty with FLEXION of knee. Swelling and fullness in popliteal area.dx and tx?

Answer 37

popliteal cyst. consider aspiration but be careful of n/v structures in area (if minimally symptomatic, observation)