Knee injuries Flashcards
Meniscal tears most commonly occur during what kind of movement?
Twisting the knee
Describe the typical clinical features of a meniscal tear
Knee:
- Pain
- Swelling
- Reduced ROM
Which special tests can be used on examination of the knee to detect a meniscal tear?
- McMurray’s test
- Apley grind test
What is the usual first-line imaging investigation for establishing a diagnosis of meniscal tear?
What is the gold standard investigation?
- First line: MRI
- Gold standard: arthroscopy
Describe the conservative, medical and surgical management of a meniscal tear
Conservative:
- RICE
- Physiotherapy
Medical:
- Analgesia (NSAIDs)
Surgical:
- Arthroscopic surgery
Which ligament in the knee is most commonly injured?
Anterior cruciate ligament (ACL)
ACL injury typically occurs during what kind of movement?
Twisting the knee
Describe the typical clinical features of ACL injury
Knee:
- Pain
- Swelling
- Reduced ROM
Which special tests can be used on examination of the knee to detect ACL injury?
- Anterior drawer test
- Lachman test
What is the usual first-line imaging investigation for establishing a diagnosis of ACL injury?
What is the gold standard investigation?
- First line: MRI
- Gold standard: arthroscopy
Describe the conservative, medical and surgical management of ACL injury
Conservative:
- RICE
- Physiotherapy
Medical:
- Analgesia (NSAIDs)
Surgical:
- Arthroscopic surgery
Describe the pathophysiology of Osgood-Schlatter disease
Inflammation at the tibial tuberosity where the patellar tendon inserts
In which age group is Osgood-Schlatter disease most common?
Teenagers
What sign will you typically find on inspection of the anterior knee in Osgood-Schlatter disease?
Visible lump on the anterior aspect of the knee (which is initially tender, but becomes non-tender over time as the bone heals)
Typically, knee pain is exacerbated by (…?) in Osgood-Schlatter disease
Physical activity
Describe the conservative and medical management of Osgood-Schlatter disease
Conservative:
- RICE
- Physiotherapy
Medical:
- Analgesia (NSAIDs)
What is a Baker’s cyst?
Fluid-filled sac (cyst) in the popliteal fossa
What causes a Baker’s cyst?
- Can occur following knee injury, e.g. meniscal tear
- Most commonly occur secondary to degenerative changes (osteoarthritis) in older adults
Describe the typical clinical features of a Baker’s cyst
Knee:
- Pain
- Swelling
- Reduced ROM
On examination of the knee, what sign is characteristic of a Baker’s cyst?
Foucher’s sign:
- Lump is most apparent when patient is stood (knee is fully extended)
- When knee is flexed, lump gets smaller or completely disappears
Which investigation can be used to confirm the diagnosis of a Baker’s cyst?
USS
Is any treatment required for an asymptomatic Baker’s cyst?
No
Describe the conservative, medical and interventional management options for a symptomatic Baker’s cyst
Conservative:
- RICE
- Physiotherapy
Medical:
- Analgesia (NSAIDs)
Interventional:
- Aspiration of the cyst
