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MSK 2 LE > knee conditions > Flashcards

knee conditions Flashcards

1
Q

Patellar Fracture - ROM and MMT

A
  1. MM Knee extension
  2. Knee Ext. ROM
  3. painful end range flexion ROM
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2
Q

Pittsburg Knee Decision Criterion Rules
3 of them

A
  1. Blunt trauma or fall
  2. Inability to bear weight x4 steps immediately or in ED
  3. age <12 y/o or >50 y/o
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3
Q

Indications for Pittsburg Radiograph ( which criteria are needed)

A

Criterion 1 or Criterion 1 + Criterion 2 or 3

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4
Q

Ottawa Knee Decision Rule Criterion Rules
5 of them

A
  1. TTD head of fibula
  2. Isolated TTD patella
  3. Can’t WB x4 steps
  4. age > 55 years old
    **5. inability to flex 90*
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5
Q

Age group for patellar tendon rupture

A

younger than 40 y/o commonly

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6
Q

Age group for quad tendon rupture

A

older than 40 y/o commonly
Males 4-8x > females

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7
Q

Risk factors for tendon rupture

A
  1. Local steroid injection
  2. Prolonged corticosteroid use
  3. RA
  4. Lupus
  5. Connective tissue diseases
    *Anything that impacts connective tissue
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8
Q

Quad tendon rupture MOI

A
  • regaining balance/ rapid quad contraction
  • extensor mechanism while flexion
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9
Q

Patellar tendon rupture MOI

A
  • jump landing , high impact land
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10
Q

Physical Exam Tendon rupture ROM deficits

A
  1. absent or painful knee extension ROM
  2. painful knee flexion ROM
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11
Q

Osgood Schlatter Disease patient population ( gender, common age of onset)

A
  • Males > Females
  • Common Age of onset:
    Males: 10-15 y/o
    Females: 8-13 y/o
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12
Q

Osgood Schlatter Disease MOI

A

Repetitive loading of knee into flexion

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13
Q

Osgood Schlatter Disease ROM findings ( 2)

A
  1. Pain end-range knee flexion ROM ( AROM & PROM)
  2. Painful knee extension MMT > AROM
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14
Q

What is Osteochondritis Dissecans? What is affected and where?

A

= Type of articular cartilage defect
= Separation of articular cartilage from subchondral bone

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15
Q

What is the most common site in Osteochondritis Dissecans?

A

= Lateral part of medial condyle

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16
Q

Osteochondritis Dissecans patient population

A

Juveniles
Males > females
Greatest 10-20 y/o
Active individuals

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17
Q

Osteochondritis Dissecans MOI

A

Traumatic MOI (40-60% juveniles) or insidious onset

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18
Q

Osteochondritis Dissecans Symptomology ( 3)

A
  • Non-specific knee pain
  • Aggravated with activity, improves with rest
  • Grinding, locking, catching, popping, clicking
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19
Q

Osteochondritis Dissecans ROM findings

A

Limited/ painful knee ROM (flexion, extension)

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20
Q

How does Microfracture procedure promotes healing ( articular cartilage deficit)?

A

makes it a subchondral injury
Bone, located in the subchondral area, has healing properties

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21
Q

Meniscal Leison ROM findings

A
  1. pain at end range extension
  2. pain/ limited flexion
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22
Q

Which population will an ACL leison happen more with? 4 reasons why?

A

population: Females 2-9x > males
1. Jump landing mechanics
2. Q angle
3. Narrower intercondylar notch
4. Hormones & Laxity

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23
Q

ACL injury MOI ( 4)

A

= non- contact injury ( more common)
1. Pivoting with planted foot & extended knee
2. Deceleration & direction change / cutting maneuvers
3. Jump landing in full knee extension
4. Hyperextension or hyperflexion of the knee
= can be contact ( varus/ valgus force) but less likely

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24
Q

ACL ROM and MMT findings

A

AROM & PROM: painful/ limited all planes (acute)
MMT - weak + painful all planes

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25
Q

ACL symptomology ( 4)

A
  1. swelling right away
  2. severe pain at time of injury
  3. audible pop
  4. instability
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26
Q

PCL Sprain MOI- where does the force happen

A

Posterior force at proximal anterior tibia

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27
Q

PCL Sprain exam findings ROM and MMT ( 2)

A
  1. Limited/ painful knee ext & flexion ROM
  2. Pain with extension MMT > 90°
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28
Q

How may a PCL injury affect gait?

A

Gait: limited knee extension in stance phase

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29
Q

MCL sprain MOI

A

Valgus force (external force at lateral knee)
Rotary trauma

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30
Q

MCL Sprain patient population

A
  1. Younger > older individuals
  2. Males 2x > females
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31
Q

What may aggravate an MCL sprain?

A

activity
change in direction (ambulation),
valgus force at knee

32
Q

LCL sprain end feel

A

Guarded/ boggy end-feel with end-range ROM flexion & extension

33
Q

Those with Patellofemoral Instability are at risk for

A

osteochondral lesion and further dislocations

34
Q

Patellofemoral instability 4 presentations on physical exam

A
  1. hypermobility of PF joint
  2. ecchmosis/ swelling/ effusion ( acute phase)
  3. patellar apprehension sign
  4. peri patellar tenderness
35
Q

Patellofemoral Instability correlated with these 4 things

A
  1. Structural: smaller patella, shallow groove for patella (lateral ridge)
    Lateral tilt & lateral displacement toward extension (30°)
  2. Patella alta/ baja
  3. Quad muscle imbalance (VMO/ VL)
  4. Generalized ligamentous laxity
36
Q

Patellofemoral Instability history

A

History: Subluxation/ Dislocation of patellofemoral joint

37
Q

Patellofemoral Pain Syndrome ( PPS) patient population

A

active individuals & adolescents

38
Q

Clinical Correlations for PPS ( 6)

A
  1. muscle imbalance ( quad and hip ER/ABD)
  2. Increased femoral angle of inclination
  3. Increased femoral anteversion
  4. subtalar pronation (IR of tibia)
  5. Increased Q angle
  6. lateral retinaculum tightness
  7. limited hip extensor endurance
39
Q

Patellofemoral Pain Syndrome patient population

A
  • Athletes
  • Female Gender
40
Q

Onset of PFPS

A

insidious

41
Q

PFPS ROM and MMT findings on physical exam

A

pain with both flexion and extension ROM
painful/ weak knee extension MMT

42
Q

PFPS aggravated with

A
  • prolonged sitting
  • stairs
  • squatting
  • inclined walking
43
Q

Osteoarthropathy onset

A

insidious

44
Q

OA patient population

A

Age > 50 years
Female > Males

45
Q

Knee OA ROM findings in physical exam

A
  1. pain / limited flexion and extension ROM
  2. pain/ weak MMT
46
Q

OA aggravated with

A

w/b activities, squatting, stairs, prolonged sitting

47
Q

Arthrofibrosis is

A

Dense proliferative intra-articular and extra-articular scar tissue formation with related limitations in knee ROM

48
Q

Arthrofibrosis limited with this range of motion? How will this affect gait?

A

knee extension
limited knee extension in stance phase ( initial contact to pre swing)

49
Q

Arthrofibrosis Inhibited/ weak/ painful with what range of motion

A

knee extension

50
Q

Stiffness that is worse in the morning is present with which knee condition

A

arthrofibrosis

51
Q

end feel with Arthrofibrosis

A

firm end-feel

52
Q

Due to tensile loading on posterior LE what is a necessary screen with genu recurvatum?

A

Neurovascular

53
Q

Genu Recurvatum places compressive load on what structure

A

anteriomedial tibiofemoral joint

54
Q

Genu Recurvatum joint mobility would present with and where

A

hypermobility posterior glide with posteriolateral bias (with ER of tibia)

55
Q

ROM and MMT findings ITB friction syndrome

A
  1. end range Hip ADD
  2. weak hip ABD MMT
    + Obers test
56
Q

What direction is the force to create genu recurvatum

A

Force to anteriomedial proximal tibia

57
Q

How will Genu recurvatum present on physical exam?

A

Tibial ER,
genu varum/ valgum,
tibial varum,
excessive pronation

58
Q

This type of injury is known as jumpers knee and involves eccentric overload

A

patellar tendinopathy

59
Q

For patellar tendinopathy there is pain with what range of motions

A

+ = end range flexion
+ = MMT extension>
+ = AROM extension

60
Q

This condition commonly occurs in Long distance runners, Downhill skiers, jumping sports, weight lifters, cycling

A

IT BAND friction syndrome

61
Q

IT Band Friction Syndrome onset

A

Insidious / progressive

62
Q

IT Band Friction Syndrome aggravated with what activities

A

repeated flexion/ extension
stairs

63
Q

Genu Recurvatum places tensile load on what structure

A

posterior lateral tibiofemoral joint supporters

64
Q

local tenderness at these 3 areas
ITB friction syndrome

A

distal ITB,
Gerdy’s tubercle,
lateral femoral condyle

65
Q

What is Plica’s syndrome?

A

= synovial fluid pockets don’t dissolve in embryonic development and form the plica
= plica gets hypertrophied over time which causes increased inflammation and microtrauma

66
Q

Patient population plica syndrome

A

Any age, greatest risk at adolescence

67
Q

Plica syndrome aggravated with

A

activity/ prolonged standing & sitting/ squatting

68
Q

Plica syndrome ROM that hurts the most and less

A

Painful knee flexion ROM; less pain with active extension
Painless extension PROM (likely)

69
Q

What is baker’s fushion?

A

Intra-articular effusion
Swelling at posterior knee

70
Q

Bakers cyst ROM findings

A

pain with ROM: flexion and extension

70
Q
A
71
Q

In bakers cyst prominence of cyst increases with what motion

A

knee flexion MMT

72
Q

Superficial & deep infrapatellar (nun’s knee) bursitis is the result of

A

Direct mechanical irritation

73
Q

Prepatellar bursitis is the result of

A

Recurrent anterior knee trauma

74
Q

Superficial Pes Anserine bursitis is the result of

A

Structures between MCL/ pes anserine
*** Swimmers/ distance runners

75
Q

superficial fibular nerve motor distribution

A

Fibularis Longus & Brevis

76
Q

superficial fibular Sensory Distribution

A

Distal 2/3 lateral leg/ ankle/ dorsal foot

MSK 2 LE (12 decks)

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