Knee Pathology

Question 1

Ottawa Knee Rules

Answer 1

1. 55 y.o or older
2. Isolated tenderness to patella
3. Tenderness at head of fibula
4. Inability to flex to 90 degrees OR inability to weight bear immediately and in emergency department (4 steps)
   - Sensitivity = 98.5%
   - Specificity = 48.6%

Question 2

Pittsburgh decision rules

Answer 2

1. Age: < 12 years old or > 50 yeas old
2. Inability to walk 4 weight bearing steps in emergency department
   - Sensitivity = 99%
   - Specificity = 60-79%

Question 3

Wells Clinical Prediction Rule

Answer 3

> /= 3 = high risk for DVT (75%)
1-2 = moderate risk for DVT (17%)
<1 point = low risk for DVT (3%)

Question 4

Sinding-Larsen-Johansson Syndrome

Answer 4

• Traction injury of knee extensor mechanism at junction of patellar ligament and inferior pole of patella
• Localized pain worsened with exercise
• Tightness of muscles, local tenderness, inflexible knee joint

Question 5

Osgood Schlatter

Answer 5

• Pulling away of tibial tubercle from patellar ligament

Question 6

Kellgren-Lawrence Scale Grade 1

Answer 6

Doubtfull narrowing of joint space and possible osteophytic lipping

Question 7

Kellgren-Lawrence Scale Grade 2

Answer 7

Definite osteophytes, definite narrowing of joint space

Question 8

Kellgren-Lawrence Scale Grade 3

Answer 8

Moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bone contour

Question 9

Kellgren-Lawrence Scale Grade 4

Answer 9

Large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone contour