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knee conditions Flashcards

1
Q

what are s&s of pre-patellar bursitis?

A

swelling and bruising over the anterior knee
pain over the anterior patella

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2
Q

what are s&s of infrapatellar bursitis?

A

swelling and bruising just below the patella
pain over the anteroinferior patella

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3
Q

which muscles attach to the pes anserine?

A

sartorius
gracilis
semintendinosus

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4
Q

what are risk factors for developing pes anserine bursitis?

A

overweight
women
ankle hyperpronation
cyclist

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5
Q

what are s&s for pes anserine bursitis?

A

localised pain over the pes anserine
painful knee flexion

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6
Q

what is the management for pes anserine bursitis?

A

rest, avoid aggravating activities
trp of affected muscles
orthotics

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7
Q

what are s&s for semimebranous bursitis?

A

pain at tendon insertion or in bursa between the tendon & medial head of gastroc on the posterior knee

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8
Q

what are the s&s of biceps femoris bursitis?

A

pain and swelling at biceps femoris tenson at the head of the fibula (posterior)
(common in sprinters due to overuse)

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9
Q

what are the s&s for popliteus bursitis?

A

localised pain in the posterolateral knee
tendon can be palpated with knee at 90° under resisted medial rotation of tibia

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10
Q

what is a baker’s cyst?

A

fluid-filled sac in the medial popliteal fossa
most commonly originates from the medial hamstring tendon

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11
Q

what are s&s of a baker’s cyst?

A

pain, fullness, stiffness in the posterior knee
fluctuant swelling and tenderness of the posterior knee
decreased ROM if its a large cyst
aching in the popliteal fossa

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12
Q

when is the foucher’s sign positive?

A

if the baker’s cyst disappears when the knee is flexed

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13
Q

what is chondrocalcinosus?

A

calcification of the cartilage/meniscus

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14
Q

what are the risk factors for developing chondrocalcinosus?

A

dehydration
diuretics

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15
Q

what is gout?

A

build up of uric acid crystals (occurs from breakdown of purine: alcohol, game meats and fish)

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16
Q

what is the most common site for gout to occur?

A

1st metatarsal joint

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17
Q

what are s&s for gout?

A

red, hot and swollen joints (need to rule out septic arthritis)

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18
Q

what is the pharmaceutical treatment for gout?

A

allopurinol

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19
Q

what is the most common site for CPPD or pseudogout to occur?

A

knee
triangular fibrocartilage

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20
Q

what are risk factors for developing CPPD?

A

> 50-60 years
diabetes
hyperparathyroidism
gout

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21
Q

which meniscus is most commonly affected?

A

medial meniscus

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22
Q

what are s&s for a meniscal tear?

A

pain within the joint line
painful clicking, popping and locking
swelling
+ve McMurray’s test
reduced ROM

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23
Q

what is the imaging of choice for a meniscal tear?

A

MRI

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24
Q

what is a parrot break in the knee?

A

a visible lump with leg at 45° when lateral meniscus is torn

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25
Q

what is a cleavage tear in the knee?

A

posterior horn of the medial meniscus is torn

26
Q

what is the Osgood-Schlatter disorder?

A

traction apophysitis (growth plate inflammation) of the tibial tuberosity due to repetitive stress by the patella tendon

27
Q

who is most at risk for developping Osgood Schlatter disorder?

A

sporty boys (up to 16 yrs)

28
Q

what are s&s for osgood Schlatter disorder?

A

prominent bulge over tibial tuberosity (anterior knee)
pain on kneeling down
pain on going up and down stairs
pain, swelling and tenderness over the tibial tuberosity
RROM extension

29
Q

what is the imaging of choice for osgood schlatter disorder?

A

x-ray

30
Q

what is the management for osgood schlatter syndrome?

A

self limiting 12-24 months
anti-inflammatory analgesic
stretching quads and hamstrings
graded return to sport

31
Q

what is osteochondritis dissecans?

A

necrosis of segments of the femoral condyle which may form intra-articular loose bodies

32
Q

what is the most common site for osteochondritis dissecans?

A

lateral aspect of the medial femoral condyle

33
Q

who is most likely to develop osteochondritis dissecans?

A

boys between 5-15 years

34
Q

what are s&s of osteochondritis dissecans?

A

poorly localised aching knee pain
swelling
worse with strenuous activity and twisting motions of knee (particularly internal rotation
patient may walk with externally rotated leg
knee locking (knee gives away when walking)

35
Q

what are the s&s of osteonecrosis?

A

persistent pain, swelling and stiffness
pain often worse at night

36
Q

what is the imaging of choice for osteonecrosis?

A

MRI (x-ray may only show after 3 months)

37
Q

what is the management for osteonecrosis?

A

avoid sport or precipitating activities for 6-8 weeks
gentle physical therapy
analgesics
grade III and IV need surgery

38
Q

which type of athletes are most at risk for developing patella tendinitis?

A

sports including repetitive jumping (basketball, volleyball, football, high jumps)

39
Q

what are s&s of patella tendinitis?

A

gradual onset anterior knee pain (below the patella)
pain worse with activity and better with rest
localised swelling over patella tendon

40
Q

what is the management for patella tendinitis?

A

avoid sport and precipitating activities
stretching of calves, hamstrings and quads

41
Q

what is patellofemoral pain syndrome?

A

pain over the anterior knee due to overuse of the knee
(most common in young females 13-15 yrs due to greater hip adduction)

42
Q

what are s&s of patellofemoral pain syndrome?

A

pain behind the patella and deep knee
crepitus within the patella
pain on compression and side-to-side movement of the patella
‘movie sign’: has to straighten out leg after prolonged sitting
pain is worse with loaded knee flexion activities (climbing stairs, walking down slopes, squatting and prolonged sitting)

43
Q

what is the management for patellofemoral pain syndrome?

A

VMO and quad strengthening (eccentric > concentric)
hip abductor strengthening
foot orthotics for hyperpronation
patella taping
acupuncture

44
Q

what is the most common cause of a quadriceps strain?

A

forceful contraction during forced muscle lengthening

45
Q

what are s&s of quadriceps rupture?

A

sudden pain over quadriceps
pop or sensation like an elastic band snapping
palpable defect in quadriceps or infrapatellar tendon

46
Q

what is the most common mechanism of injury for an anterior cruciate ligament (ACL) sprain?

A

twisting of knee
sudden change in direction
blow through foot with a flexed knee

47
Q

what are the s&s for ACL sprain?

A

onset of severe pain after sports injury
swelling (within 30 min)
feeling as if knee gives away or is loose
inability to weight bear
painful ROM

48
Q

which special tests would be positive in ACL sprain?

A

lachman’s test
anterior draw test
pivot shift test

49
Q

which ligaments/structures are associated with the unhappy triad of the knee?

A

ACL
medial meniscus
MCL

50
Q

what is the imaging of choice for an ACL sprain?

A

MRI

51
Q

what is the mechanism of injury in a posterior cruciate ligament (PCL) sprain?

A

A-P blow to tibia in a flexed knee (with foot plantar flexed creating reduced tibial stabilisation)

52
Q

what are the s&s for PCL sprain?

A

pain in posterior knee
pain radiating into calf
limited running/jumping
no moderate swelling
genu rectuvatum

53
Q

which tests are positive in PCL strain?

A

posterior sag sign
+ve posterior draw

54
Q

what is the management for grade 1-2 PCL sprain?

A

graded rehabilitation program
0-4 weeks: brace in slight flexion + RICE
2-6 weeks: dynamic ROM exercises, static cycling and quad strengthening
4-12 weeks: closed chain: half squats, leg presses, resistance cycling, light jogging
> 12 weeks: return to activity
return to sport if quad and hamstring strength are 90% of non-involved side (4-6 weeks)

55
Q

what is the management for a grade 3 PCL sprain?

A

surgical referral

56
Q

what is the synovial plica syndrome?

A

fold of synovium which gets caught between the patella and femur during walking

57
Q

what are s&s of plica syndrome?

A

acute aching in the medial patellofemoral joint
mild effusion

58
Q

what is the management for synovial plica syndrome?

A

generally resolves without treatment
US
cross-friction
electrical stimulation

59
Q

what are s&s of popliteus tendonitis?

A

localised tenderness in posterior/posteriolateral knee
pain provoked by running and prolonged standing
TTP popliteus tendon (with knee at 90°)
pain in resisted tibial rotation

60
Q

what are s&s of pes anserine tendonitis?

A

localised tenderness over pes anserine tubercle

61
Q

what are s&s for semimembranosus tendonitis?

A

tenderness over insertion into the posteromedial tibia

62
Q

what are s&s of biceps femoris tendonitis?

A

tenderness over the insertion into the posterolateral tibia

conditions (29 decks)

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