Knee

Question 1

What are the findings the Ottawa knee rules requires for x-ray requirement?

Answer 1

1. > 55 yoa
2. isolated patellar tenderness
3. tenderness of head of fibula
4. inability to flex to 90
5. inability to WB both immediately and in ED (4 steps)

Question 2

What are the psychometric properties related to ottawa knee rules?

Answer 2

98.5% sensitivity

~50% specificity

Question 3

Wells CPR is for:

Answer 3

DVT risk

Question 4

Age 3-10, dxx for knee pain may include:

Answer 4

legg-calve-perthes

Question 5

Age 10-14, dxx for knee pain may include:

Answer 5

slipped femoral capital epiphysis

Question 6

Dxx for knee pain in older population:

Answer 6

hip OA

hip AVN

Question 7

Wells CPR includes:

Answer 7

active CA
paralysis/immobilization
localized tenderness along venous distribution
entire leg swollen
unilateral pitting edema
bedridden > 3 days due to surgery
collateral superficial veins

Question 8

pittsburgh decision rules

Answer 8

Pts. who should undergo radiography after knee trauma:
Blunt trauma or a fall as mechanism of injury plus either of the following:
< 12 yo or > 50 yo
Inability to walk 4 steps in the ED

99% sensitive and 60-79% specific for the diagnosis of knee fractures.

Question 9

An tangential angle > 138 degrees at the patellofemoral joint puts pt. at risk for:

Answer 9

subluxation

Question 10

What two apophysitis syndromes are common in the knee joint?

Answer 10

Sinding-Larsen-Johansson syndrome

Osgood-Schlatter

Question 11

Describe Sinding-Larsen-Johansson syndrome:

Answer 11

apophysitis of distal patella

Question 12

Describe Osgood-Schlatter:

Answer 12

apophysitis of the tibial tuberosity

Question 13

What grading scale is commonly used for knee OA?

Answer 13

Kellgren-Lawrence (grade 1-4)

Question 14

Describe the kellgran lawrence grading scale:

Answer 14

Grade 1: doubtful narrowing of joint space and possible osteophytic lipping
Grade 2: definite osteophytes, definite narrowing of joint space
Grade 3: mod. multiple osteophytes, definite narrowing of joints space, some sclerosis and possible deformity of bone contour
Grade 4: large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone contour

Question 15

What is the Positive femoral line sign?

Answer 15

Femur translates posteriorly on Tibia