Knee

Question 1

Ottawa knee rules

Answer 1

conventional radiographs should be ordered after trauma to the knee for patients with any of the following:

age older than 55 years

tenderness at fibular head

isolated tenderness of patella

inability to flex knee to 90 degrees

inability to walk 4 weight bearing steps immediately after injury and in the emergency department

Question 2

Knee radiographs

Answer 2

AP-

Lateral-

Intercondylar Fossa View (tunnel view)-

Tangential patellofemoral view (sunrise view)-patient supine, knee flexed 45 degrees off end of table

Question 3

MRI

Answer 3

articular cartilage, ligaments, tendons, and menisci

axial
sagittal
coronal

Question 4

Knee MR Arthrogram

Answer 4

identifies post opm meniscus tears/retears, loose bodies, chondromalacia, osteochondral fracure of the patella

Question 5

CT

Answer 5

assess severe trauma, assess alignment and displacement of fracture fragments, identify loose bodies of the joint, eval tibial plateau depression fractures, and when MRI contraindicated

axial
sagittal
coronal
3D format

Question 6

MSUS of knee

Answer 6

detect soft tissue injury

visualize capsule, synovium, and bursas

define ligament, muscle, or tendon tear

Question 7

Fracture of the femur

Answer 7

imaging-radiographs are diagnostic, CT may be needed for fragment localization

Question 8

Fracture of the tibial plateau

Answer 8

imaging-radiographs are diagnostic. 3D CT may assist with surgical planning, MRI will define occult fractures via bone marrow edema.

Question 9

Osteochondritis dissecans (OCD)

Answer 9

imaging-Radiographs

MRI will determine the vascularity of the lesion

Question 10

Tear of the ACL

Answer 10

imaging-radiographs to rule out potential avulsion fractures at the site of cruciate ligament

sagittal MRI shows disruption in the linear continuity of the ACL in complete tears

Question 11

Degenerative join disease

Answer 11

imaging-radiographs the hallmark of DJD