Knee Problems - Acute Injuries of the Knee

Question 1

what may cause knee pain?

Answer 1

fracture
acute on chronic degenerative joint disease
meniscal injury
ligament injury
tendon injury

Question 2

in knee pain what do you want to get from the hx?

Answer 2

• Environment
o Sport or recreation
o Workplace
• Activity
o Sports tackle
o Jumping
• Energy
o How fast and how heavy
• Systemic symptoms
• Chronology
o Quick or slow onset
o Previous injury or event
• Hear or feel pop or crack
• Swelling
o Early or late onset
o Early means haemarthrosis

Question 3

mechanism of meniscal injury

Answer 3

twisting movements on a loaded fixed knee
painful squelch
swelling is slow but quicker in youn

Question 4

symptoms of meniscal injury

Answer 4

pain on weight bearing

locked knee

Question 5

management of meniscal injury

Answer 5

meniscal repair
partical menisectomy
meniscal tranplantation

Question 6

shape of medial meniscus

Answer 6

semi-circular

Question 7

shape of lateral meninscus

Answer 7

circular

Question 8

structure of meniscus

Answer 8

fibro and chondroblasts in matrix of type 1 collagen

radial and circumferential fibers

Question 9

mechanism of ACL tear

Answer 9

forward momentum, leg fixed and with or without rotation

pop often felt with quick swelling

Question 10

symptoms of ACL tear

Answer 10

unable to weight bear

Question 11

mechanism of collateral tears

Answer 11

crack and sharp pain

Question 12

symptoms of collateral tears

Answer 12

localised pain
no or minimal effusion
bruising to one side of the knee

Question 13

examination of knee ligament injuries: look for

Answer 13

scars
bruising
swelling
joint line irregularity

Question 14

examination of knee ligament injuries: feel for

Answer 14

effusion
crepitus
heat
tenderness
tissue lumps or defects

Question 15

examination of knee ligament injuries: move

Answer 15

passiv and active
straight leg raise
range of movement
ligament testing
dynamic testing

Question 16

what may you see on knee xrays

Answer 16

fracture
loose bodies
ligament avulsion
osteochondral defect
degenerative joint disease
lipohaemoarthrosis

Question 17

what may you see on knee uss?

Answer 17

tendon rupture
some meniscal tears
swelling
cysts

Question 18

what may you see on knee MRI?

Answer 18

clinical confirmation
variable sensitivity and specificity
not good for DJD or mobile pathology

Question 19

management of knee pain: surgery

Answer 19

joint perservation

life-long care of the joint

Question 20

indications for surgery in knee pain

Answer 20

failure of conservative Rx
demands of work
demands of sport
problems with daily activities
prevention of further joint injury
prevention of falls

Question 21

management of knee pain: non-surgical

Answer 21

restoration of function
physio
analgesia
swelling reduction
range of motion
normal movement