kneeded me (rihanna 2016) Flashcards
what is a meniscal tear
when one of the menisci either medial or lateral tears
can be bucket handle tear
parrot beak tear
flap tear/horizontal cleavage
what causes meniscal tears
usually traumatic from playing sports - knee gets bent and twisted
degeneration in older people
how does a meniscal tear present
intense pain, swelling and joint locking in an acute tear
may be painless in a chronic tear
what are clinical signs of a meniscal tear
clicking/popping sensation in bucket handle tear catching sensation in parrot beak tear effusion muscle wasting - quads tender joint line on side of tear
what investigations could you do for meniscal tears
mcmurrays test - click
fail deep squat walking
thalasseys test - positive
X-ray - rule out fracture, OA etc
how can you manage meniscal tears
rest
analgesics
physio
surgery
what causes anterior cruciate ligament tear
twisting of knee after planting foot - valgus knee angulation
more common in females
how does anterior cruciate ligament tear present
deep pain
immediate swelling
popping/cracking sensation
what are clinical signs of anterior cruciate ligament tear
haemarthesis femur moves forward in anterior draw test effusion tenderness lachmann's test
what investigations could you do for anterior cruciate ligament tear
X-ray for fracture
MRI - exclude unhappy triad
arthoscopy
how do you manage anterior cruciate ligament tear
NSAIDs
physio
surgery
what is the unhappy triad
anterior cruciate tear
medial meniscus tear
medial collateral ligament tear (can sometimes be lateral collateral ligament)
what causes medial collateral ligament tear
contact sports
severe valgus stress
how does medial collateral ligament tear present
pop/crack sensation
bruising and pain on medial side
swelling
what are clinical signs of medial collateral ligament tear
pain on full extension
tenderness at femoral insertion of ligament
often the medial meniscus is damaged too - tender medial joint line suggests this
what investigations could you do for medial collateral ligament tear
x-ray
MRI
how could you manage medial collateral ligament tear
analgesics rest physio brace surgery if severe
what is osteochondritis dissecans
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
what causes osteochondritis dissecans
irradiation fracture dislocation steroids coagulopathies iatrogenic
what are risk factors for osteochondritis dissecans
male
35-50
alcohol
what investigations could you do for osteochondritis dissecans
MRI
X-ray
how does osteochondritis dissecans present
insidious onset of groin pain
limp
reduced internal rotation
how could you manage osteochondritis dissecans
restrict weight bearing
brace
arthroscopic fixation of loose fragment
open surgery if needed
which meniscus is most commonly injured?
The medial meniscus
What are the white and red zones of the meniscus?
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.
what test confirms a meniscal injury?
MRI
what is always present in an anterior cruciate ligament injury?
Haemarthrosis.
what is the most commonly injured ligament of the knee?
Medial collateral ligament
what are the main risk factors for avascular necrosis?
Male
35-55yrs
alcohol
80% is bilateral
where is the most common area of the labrum of the hip to tear?
Anterior/superior.
what type of hip dislocation is most common?
90% are posterior dislocations. - foot pointing inwards
10% anterior dislocation. - foot pointing outwards
Which nerve is most commonly affected in hip dislocations?
sciatic nerve.
