kneeded me (rihanna 2016)

Question 1

what is a meniscal tear

Answer 1

when one of the menisci either medial or lateral tears
can be bucket handle tear
parrot beak tear
flap tear/horizontal cleavage

Question 2

what causes meniscal tears

Answer 2

usually traumatic from playing sports - knee gets bent and twisted
degeneration in older people

Question 3

how does a meniscal tear present

Answer 3

intense pain, swelling and joint locking in an acute tear

may be painless in a chronic tear

Question 4

what are clinical signs of a meniscal tear

Answer 4

clicking/popping sensation in bucket handle tear
catching sensation in parrot beak tear 
effusion 
muscle wasting - quads 
tender joint line on side of tear

Question 5

what investigations could you do for meniscal tears

Answer 5

mcmurrays test - click
fail deep squat walking
thalasseys test - positive
X-ray - rule out fracture, OA etc

Question 6

how can you manage meniscal tears

Answer 6

rest
analgesics
physio
surgery

Question 7

what causes anterior cruciate ligament tear

Answer 7

twisting of knee after planting foot - valgus knee angulation
more common in females

Question 8

how does anterior cruciate ligament tear present

Answer 8

deep pain
immediate swelling
popping/cracking sensation

Question 9

what are clinical signs of anterior cruciate ligament tear

Answer 9

haemarthesis
femur moves forward in anterior draw test 
effusion
tenderness 
lachmann's test

Question 10

what investigations could you do for anterior cruciate ligament tear

Answer 10

X-ray for fracture
MRI - exclude unhappy triad
arthoscopy

Question 11

how do you manage anterior cruciate ligament tear

Answer 11

NSAIDs
physio
surgery

Question 12

what is the unhappy triad

Answer 12

anterior cruciate tear
medial meniscus tear
medial collateral ligament tear (can sometimes be lateral collateral ligament)

Question 13

what causes medial collateral ligament tear

Answer 13

contact sports

severe valgus stress

Question 14

how does medial collateral ligament tear present

Answer 14

pop/crack sensation
bruising and pain on medial side
swelling

Question 15

what are clinical signs of medial collateral ligament tear

Answer 15

pain on full extension
tenderness at femoral insertion of ligament
often the medial meniscus is damaged too - tender medial joint line suggests this

Question 16

what investigations could you do for medial collateral ligament tear

Answer 16

x-ray

MRI

Question 17

how could you manage medial collateral ligament tear

Answer 17

analgesics
rest 
physio 
brace 
surgery if severe

Question 18

what is osteochondritis dissecans

Answer 18

when part of bone dies due to lack of blood supply - avascular necrosis
tissue dies and bone collapses
usually bilateral
usually in knee but can be elsewhere

Question 19

what causes osteochondritis dissecans

Answer 19

irradiation 
fracture
dislocation
steroids
coagulopathies
iatrogenic

Question 20

what are risk factors for osteochondritis dissecans

Answer 20

male
35-50
alcohol

Question 21

what investigations could you do for osteochondritis dissecans

Answer 21

MRI

X-ray

Question 22

how does osteochondritis dissecans present

Answer 22

insidious onset of groin pain
limp
reduced internal rotation

Question 23

how could you manage osteochondritis dissecans

Answer 23

restrict weight bearing
brace
arthroscopic fixation of loose fragment
open surgery if needed

Question 24

which meniscus is most commonly injured?

Answer 24

The medial meniscus

Question 25

What are the white and red zones of the meniscus?

Answer 25

Red zone - lateral 1/3rd - has a blood supply. repair meniscal injury if its in the red zone.
White zone - medial 2/3rds - has no blood supply. resent if its in the white zone.

Question 26

what test confirms a meniscal injury?

Answer 26

MRI

Question 27

what is always present in an anterior cruciate ligament injury?

Answer 27

Haemarthrosis.

Question 28

what is the most commonly injured ligament of the knee?

Answer 28

Medial collateral ligament

Question 29

what are the main risk factors for avascular necrosis?

Answer 29

Male
35-55yrs
alcohol
80% is bilateral

Question 30

where is the most common area of the labrum of the hip to tear?

Answer 30

Anterior/superior.

Question 31

what type of hip dislocation is most common?

Answer 31

90% are posterior dislocations. - foot pointing inwards

10% anterior dislocation. - foot pointing outwards

Question 32

Which nerve is most commonly affected in hip dislocations?

Answer 32

sciatic nerve.