Knee Lecture Flashcards
1
Q
Possible remote/serious knee pathology
A
- Patella or Tibial Plateau Fracture (OKR)
- DVT
- Osteochondritis Dissecans
- Lyme disease
- Compartment syndrome
- Syphilis
- Septic arthritis
- Gout
- Popliteal Cyst (Baker’s Cyst)
2
Q
Ottawa Knee Rules to send of an X-ray
A
- Age >55
- Isolated tenderness of patella (no other knee bone tenderness)
- Tenderness of the head of the fibula
- Inability to flex knee >90º
- Inability to WB both immediately & in the ED regardless of limping
3
Q
What are the 6 P’s of compartment syndrome
A
- Pain
- Palpable tenderness
- Paresthesia
- Paresis
- Pallor
- Pulselessness
4
Q
Illness script for compartment syndrome
A
- 6 P’s
- Acute usually due to trauma
- Pain with passive stretch
- Symptom emergency
- Typically runners, soccer players, and in the anterior compartment
- Key sx: pain out of proportion to clinical situation is usually first Sx
5
Q
Describe primary versus secondary type of Syphilis arthritis
A
- Syphilis is a STI (soft tissue infection)
- Primary: single sore (mouth or genitals)
- Secondary: rash/sores not in the above areas; fever/sore throat; muscle aches & joint pain; synovitis
- Need medical treatment to prevent dementia & paralysis
6
Q
Describe Herpes Gladiatorum
A
- High risk = athletes with close contact (ex: rugby & wrestling)
- Person to person contact
- Equipment to person contact
7
Q
Other soft tissue infections
A
- Bacterial skin & soft tissue infections
- Tinea gladiatorum
- Varicella zoster virus
- Scabies
8
Q
Illness script for Osteochondirtis dissecans
A
- Mostly in children & adolescents
- Segment of bone cracks & loosens away resulting in loosening of cartilage as well
- Disruption of blood supply possibly from repetitive jumping/loading
- Treatment: relative rest mostly and Sx modification
9
Q
Possibilities for medial knee pain
A
- Medial collateral ligament sprain
- Medial meniscal tear
- Pes anserine bursitis
- Medial plica syndrome
10
Q
Possibilities for anterior knee pain
A
- Patellar subluxation or dislocation
- Tibial apophysitis (Osgood-Schlatter lesion)
- Jumper’s knee (patellar tendonitis)
- Patellofemoral pain syndrome (chondromalacia patellae)
11
Q
Possibilities for lateral knee pain
A
- Lateral collateral ligament sprain
- Lateral meniscal tear
- Iliotibial band tendonitis
12
Q
Possibilities for posterior knee pain
A
- Popliteal cyst (Baker’s cyst)
- Posterior cruciate ligament injury
13
Q
How do you classify Patellofemoral Pain Syndrome
A
- Presence of retrropatellar or peripatellar pain AND
- Repoduction of etropatellar or peripatellar pain with squatting, sitting, stair climbing or other functional activities that load the PF joint in a flexed position AND
- Exclusion of other conditions that may cause anterior knee pain
14
Q
Describe Zohler sign
A
- Grasp the patella and apply a caudal glide then ask the patient to contract the quad
- Positive = retropatella pain
15
Q
Describe Clarke test (AKA Patella Grind)
A
- Add a mild compression to the patella & ask patient to contract the quad
- Positive = retropatella pain
