Knee Pain

Question 1

Ruptured anterior cruciate ligament

• type of injury?
• how does it occur?
• presentation?
• tests can you do for Dx?
• more reliable test than the one above ?
• heal well or poorly?
• Mx?

Answer 1

Sport injury

Mechanism: high twisting force applied to a bent knee

Typically presents with: loud crack, pain and RAPID joint swelling (haemoarthrosis)

Aanterior draw test: knee at 90 degrees

Lachman’s test: knee at 30 degrees - more reliable than anterior draw test

Poor healing

Management: intense physiotherapy or surgery

Question 2

Ruptured posterior cruciate ligament

• how does it occur?
• what test can you do for Dx?

Answer 2

Mechanism: hyperextension injuries, usually head on car crash

+ve posterior draw test

Question 3

Menisceal tear

• how does it occur?
• swelling rapid or slow?
• characteristic feature?

Answer 3

Rotational sporting injuries

Delayed knee swelling

Joint locking (Patient may develop skills to 'unlock' the knee 
and ' giving way ' are common features

Question 4

Chondromalacia patellae

• occurs in whom?
• what occurs?
• when does pain occur?
• wasting of which muscle group?

Answer 4

Teenage girls,

following an injury to knee e.g. Dislocation patella

Typical history of pain on going downstairs or at rest

quadriceps wasting