Knee lecture - Piers Yates

Question 1

varus deformity of the knee

Answer 1

the limb segments deviate in the coronal plane

Question 2

valgus deformity of the knee

Answer 2

Question 3

a deformity of the knee may result from

Answer 3

• loss of joint space due to articular cartilage wear
• ligamentous tears
• bone deformity

Question 4

what is flexion deformity of the knee?

Answer 4

inability to full straighten or extend the knee

Question 5

what is recurvatum deformity of the knee?

Answer 5

also called hyper-extension deformity
knee bends backwards

Question 6

what causes the largest numbers of knee deformity?

Answer 6

poliomyelitis
especially recurvatum deformity

Question 7

what is osteoarthritis

Answer 7

common disease of the synovial joints
the hyaline articular cartilage joint surfaces wear away
primary osteoarthritis is when the aetiology is unknown
secondary osteoarthritis is when the aetiology is known

Question 8

some causes of secondary osteoarthritis

Answer 8

infection, trauma, or rheumatoid arthritis

Question 9

radiological features of osteoarthritis

Answer 9

joint space narrowing
sun-chondral sclerosis
osteophytes
sub-articular cysts

Question 10

conservative treatment of osteoarthritis

Answer 10

pain relief
analgesics, NSAIDs
weight loss
physiotherapy and use of a stick
orthotics
infections, steroids, hylagan lubricants
joint washout (lavage)

Question 11

surgical treatment for osteoarthritis

Answer 11

arthroscopic washout and debridement, surface drilling, micro fracture treatment
osteotomy
arthrodesis
arthroplasty - excision or replacement

Question 12

bursae around the knee

Answer 12

1. prepatellar
2. superficial infrapatellar
3. suprapatellar
4. deep infra patellar
5. popliteal or semi- membranes bursa (baker’s cyst)

Question 13

popliteal cysts

Answer 13

the synovial cavity of the knee extends into the popliteal fossa
Indicates pathology of the knee (OA, RA, gout etc.)

Question 14

natural history of popliteal cysts

Answer 14

disappear gradually
rupture suddenly
mimic DVT
venogram normal
arthrogram will show fluid leak

Question 15

clinical features of rheumatoid arthritis

Answer 15

symmetrical swelling in small joints
young adults 15-35
women > men
synovial swelling best seen in fingers and in valleys between metacarpal heads
joints stiff in the morning - ease during the day
systemic disease, subcutaneous nodules

Question 16

x-ray features of rheumatoid arthritis

Answer 16

small joints of the hands affected, hips usually spared
bones are osteoporotic
periarticular erosions
tricompartmental in the knee