Knee and Lower Leg

Question 1

Possible Causes of Acute Leg and Knee Pain

Answer 1

Musculotendinous sprains/strains
Fractures
Dislocations
Compartment syndrome
Ligamentous injuries
Extensor Mechanism Injuries
Meniscal Injuries

Question 2

Gastrocnemius Contusion S&S

Answer 2

Immediate pain and weakness

Rapid Hemorrhage and Muscle spasm

Question 3

Gastrocnemius Contusion Managment

Answer 3

Cold with Gentle Stretch

Question 4

Tibial Contusion (shin bruise)

Answer 4

vulnerable lack of padding
repeated blows could damage periosteum
the key is prevention

Question 5

Acute Compartment Syndrome MOI

Answer 5

Direct blow anterolateral aspect of the tibia

Question 6

Acute Compartment Syndrome Consequence

Answer 6

Rapid increase in tissuse pressure –> neurovascular compromise

Question 7

Acute Compartment Syndrome S&S

Answer 7

History of Trauma
Increasingly severe pain
Firm and tight skin over anterior shin
Loss of sensation between 1st and 2nd toes on dorsum of foot
Diminished Pulse (Dosalis pedis artery)
Functional abnormalities within 30 min

Question 8

Acute Compartment Syndrome Management

Answer 8

Cold, no compression or elevation

Immediate physician referral because irreversible damage can occur within 12-24 hours

Question 9

Exertional Compartment Syndrome

Answer 9

Exercise-induced pain and swelling that is relieved by rest
Anterior compartment 50-60%
Usually in well conditioned individuals younger than 40

Question 10

Exertional Compartment Syndrome S&S

Answer 10

Aching leg pain and sense of fullness over involved compartment
Often affects both legs
Symptoms relieved with cessation of exercise
Activity-related pain begins at a predictable time
Anterior compartment - mild foot drop; paresthesia on dorsum of the foot

Question 11

Exertional Compartment Syndrome Managment

Answer 11

Assessing Contributing factors

Question 12

Peroneal Tendon Strain mechanism

Answer 12

Strong push-off a slightly pronated foot
Forceful passive dorsiflexion
Direct blow - posterior lateral malleolus

Question 13

Peroneal Tendon Strain S&S

Answer 13

Cracking sensation with intense pain and inability to walk
Swelling and point tenderness in posterior superior lateral malleolus
Extreme discomfort or apprehension during attempted eversion against resistance
Chronic –> complains of “giving way” with little discomfort

Question 14

Gastrocnemius Strain Location

Answer 14

Medial head or Musculotendinous junction

Question 15

Gastrocnemius Strain Mechanism

Answer 15

Forced dorsiflexion while knee is extended
Forced knee extension while foot is dorsiflexed
Muscular fatigue with fluid - electrolyte depletion and cramping

Question 16

Gastrocnemius Strain Mechanism S&S

Answer 16

Immediate pain, swelling, loss of function

Question 17

Gastrocnemius Strain Management

Answer 17

standard acute; gentle stretching; heel lifts

Question 18

Deep Vein Thrombosis (DVT)

Answer 18

Partial or complete blockage of a vein due to accumulated blood products that form a clot
common in the deep calf veins

Question 19

Embolism

Answer 19

Obstruction or occlusion of a vessel by bacteria or other foreign body

Question 20

Deep Vein Thrombosis (DVT) Signs

Answer 20

Parethesia in the area
Chronic Swelling and edema in the involved extremity
Engorged Veins
Eccymosis formation with a blue hue
\+ Homan's sign

Question 21

Deep Vein Thrombosis Management

Answer 21

Immediate Physician Referral