Knee

Question 1

What is knee osteoarthritis associated with than hip OA is not?

Answer 1

High BMI

Question 2

What are the primary and secondary causes of knee osteoarthritis?

Answer 2

1. Degeneration of articular cartilage and joint surfaces.

2. Due to post-traumatic/operative/infective causes.

Question 3

What is this a presentation of?
Pain in knee on initiating movement, stiffness after inactivity but resolves in under 30 mins, limited range of motion, crepitus during active and passive movement.

Answer 3

Knee osteoarthritis

Question 4

How is knee osteoarthritis investigated?

Answer 4

X-ray (LOSS features)

Question 5

What is the treatment for knee osteoarthritis?

Answer 5

Weight loss, physio, NSAIDs, TKR

Question 6

What is the unhappy triad?

Answer 6

1. MCL
2. ACL
3. Medial meniscal tear

Question 7

What causes medial and lateral meniscal tears?

Answer 7

1. Medial - twisting of flexed knee

2. Lateral - adduction and internal rotation

Question 8

What is this a presentation of?

Gradual swelling of the knee, tender medial joint line, catching, popping, locking.

Answer 8

Meniscus tear

Question 9

What is McMurray’s test and what does it identify?

Answer 9

1. Rotate flexed knee and then extend knee through rotation.

2. Meniscus tear

Question 10

How is a suspected meniscus tear investigated?

Answer 10

MRI

Question 11

What is the treatment for a meniscus tear?

Answer 11

Conservative, NSAIDs, arthroscopic meniscectomy for locked knees, cysts, or persistent tears.

Question 12

What is this a presentation of?
Rapid swelling of the knee following a twisting injury to the knee with foot fixed to ground, effusion, +ve anterior draw sign, +ve Lachman test.

Answer 12

Anterior cruciate ligament tear

Question 13

What two tests identify anterior cruciate ligament tear?

Answer 13

Anterior draw and Lachman

Question 14

How is suspected anterior cruciate ligament tear investigated?

Answer 14

MRI

Question 15

What is the treatment for anterior cruciate ligament tear?

Answer 15

Rest for 3 weeks, physio, young patients can receive ligament reconstruction.

Question 16

What is this a presentation of?

Effusion and tenderness due to a blow to the lateral side of the knee.

Answer 16

Medial collateral ligament sprain

Question 17

What is the treatment for a medial collateral ligament sprain?

Answer 17

Rest with firm support

Question 18

What causes iliotibial band syndrome and what is the presentation?

Answer 18

1. Friction of ITB over lateral aspect of tibial tuberosity during knee flexion.
2. Lateral knee pain on movement and palpation, common in runners/weight lifters.

Question 19

What is the treatment for iliotibial band syndrome?

Answer 19

Rest, ice, NSAIDs, physiotherapy, steroid injections if severe.

Question 20

What is this a presentation of?

Young athlete with recent increase in sport/trauma, knee ache after prolonged sitting/stair use, +ve Clarke’s test.

Answer 20

Patellofemoral pain syndrome

Question 21

What is the treatment for patellofemoral pain syndrome?

Answer 21

Rest, NSAIDs, quad/hip strengthening exercises.

Question 22

What does this describe?

1. Condition of 12-19 years old
2. Knee pain, catching, locking, giving way
3. Painful clunk when flexing/extending knee

Answer 22

Osteochondritis dissecans

Question 23

What does this describe?

1. Paediatric/young female condition
2. Pain worse on climbing stairs (similar to patellofemoral pain syndrome).

Answer 23

Chondromalacia patella