Knee

Question 1

Radiographs should be ordered after trauma to the knee if there is any of what 4 symptoms present?

Answer 1

• Joint effusion after direct blow or fall
• Inability to walk without limping
• Palpable tenderness over patella or fibular head
• Inability to flex knee to 90°

Question 2

Should radiographs be ordered if a patient had twisting injury and is able to walk with no effusion present?

Answer 2

No

Question 3

Isolated meniscal tears are present with what symptoms?

Answer 3

• Intermittent clicking and eventually chronic blocking or locking of knee joint motion
• Effusion
• Pain

Question 4

What is the imaging of choice for evaluating menisci?

Answer 4

MRI

Question 5

On an MRI menisci are seen as ___ signal intensity. Tears are seen as ____ signal intensity.

Answer 5

low (dark)

high (light)

Question 6

In what direction are mensical tears most commonly oriented?

Answer 6

vertically

Question 7

If there is a longitudinal extension of the vertical meniscus tear what is it called?

Answer 7

a bucket handle tear

Question 8

Meniscus tears typically occur in a horizontal orientation due to what?

Answer 8

degenerative changes in older adults

Question 9

What is the clinical presentation of a collateral ligament tear?

Answer 9

Pain, joint effusion, and instability

Question 10

The LCL is injured from a ____ force

Answer 10

varus

Question 11

The MCL is injured from a ____ force

Answer 11

valgus

Question 12

What is the unhappy triangle?

Answer 12

Tears of the MCL, ACL, and medial meniscus

Question 13

What is the imaging of choice for collateral ligament tears?

Answer 13

coronal T2-weight MRI

Question 14

In a T2-weighted MRI the collateral ligaments appear ____.

Answer 14

dark

low signal intensity

Question 15

Sports related ACL injuries occur at a rate of about how many per year in the US?

Answer 15

200,000

Question 16

Women tend to experience ACL injuries up to __ times more often than men participating in same the sport

Answer 16

8

Question 17

What is the MOI for a PCL tear?

Answer 17

external forces that strike the anterior aspect of the knee (such as in dashboard injuries)

Question 18

What is the MOI for an ACL tear?

Answer 18

non-contact forces that place great valgus and rotary stresses on knee.

Such as when an athlete suddenly decelerates, turns, and hears the classic “pop” of rupture

Question 19

Dynamic LE valgus is a combination of what 3 motions at the hip, knee, and ankle?

Answer 19

Hip: adduction and internal rotation
Knee: tibial abduction, tibial external rotation and anterior translation
Ankle eversion

Question 20

How can radiographs evaluate cruciate ligament tears?

Answer 20

When there is associated avulsion fractures

Question 21

What is the imaging of choice for cruciate ligament tears?

Answer 21

Sagittal T1-weighted MRI

Question 22

What are the 2 clinical decisions rules for the knee?

Answer 22

Ottawa and Pittsburg