Lecture 4: Knee Flashcards

1
Q

Ligaments of the knee

A

ACL
PCL
LCL
MCL
Transverse Ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which meniscus is bigger

A

Medial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the ACL do

A

Limits anterior displacement of the tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differentiate diagnosis between PFPS and Chondromalacia Patellae

A

CP: more localised pain under kneecap where cartilage is located (sharp or aching pain), Fragmented appearance of cartilage beneath kneecap on X-ray, cartilage damage on MRI

PFPS: Pain in anterior aspect of knee, around kneecap (dull, ache, burning), X-rays and MRI often inconclusive and normal signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis of PFPS

A

Insidious onset of poorly defined pain (anterior retropatellar pain/peripatellar pain).

Pain in anterior aspect of knee, around kneecap (dull, ache, burning)

Slow build up or rapid development

Worsening of pain in loading positions
o Squatting (Full ROM)
o Going up/downstairs
o Running
o Prolonged sitting (Cinema Sign)
o Jumping
o No single diagnostic

Tends to worsen with activities such as squatting, sitting, climbing stairs, and running (aggravating factors)

Exclusion of other conditions that may cause anterior knee pain
o Chondromalacia Patellae
o Patella tendinopathy
o ITBS
o Meniscus tear
o Ligament injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differential diagnosis for PFPS

A

Chondromalacia Patellae: more localised pain under kneecap where cartilage is located (sharp or aching pain), Fragmented appearance of cartilage beneath kneecap on X-ray, cartilage damage on MRI

Patella tendinopathy: localised pain at inferior pole of patella tendon

ITBS: more lateral pain, pain in calf, band flicking knee cap

Meniscus tear: McMurray’s Test

Ligament injuries:
ACL: Lachman’s, Anterior Drawer, Pivot Shift
PCL: Posterior Drawer
LCL: Varus Stress Test
MCL: Valgus Stress Test
Meniscus: McMurray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Normal Knee Flexion and Extension

A

Flexion: 135
Extension: 0 to -5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diagnosis of Patella Tendinopathy

A

Pain localised in the tendon (inferior pole of the patellar or distal patellar tendon)

Load-related pain with a dose response component
Pain free at rest
Pain in a few cases can decrease with loading (warm up phenomenon), but it’s often increased the day after
Reduced strength in hip abduction, ER and extension
Reduced strength calf muscles
Reduced flexibility
Excessive foot pronation

Test: Patella Tendon Palpation, and Royal London Hospital Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnosis of Knee OA

A

Knee pain
Gradual onset, worsening with activity
Stiffness and swelling
Crepitus
Loss of ROM
Pain after prolonged sitting/resting
Age (older)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diagnosis of Fat Pad Impingement

A

Increase in pain involving passive/active knee extension
Palpation
Also pain with movements close to EOR flexion once fat pad is swollen (patella can’t glide down)
A patient’s history may help to differentiate patellar tendinopathy from typical fat pad irritation. The patient with PT must have a history of eccentric loading of the quadriceps muscle such as running downhill, whereas a patient with a fat pad irritation presents after forceful extension manoeuvre
Hoffa’s Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What test would you use for a meniscus tear

A

McMurray’s Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What tests would you use for an ACL sprain

A

Lachman’s Test
Anterior Drawer Test
Pivot Shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What tests would you use for an LCL sprain

A

Varus Stress Test
(Adduction of Tibia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What tests would you use for an MCL sprain

A

Valgus Stress Test
(Abduction of tibia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What tests would you use for a PCL sprain

A

Posterior Drawer, Sag sign, Reverse pivot shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Knee observations in a physical assessment

A

Front on
Compare sides, identify patella/contour, look at femoral internal rotation, genu valgus/varus

Side on
Hyperextended/over flexed knee

17
Q

Which test would you use for the MCL

A

Valgus Stress Test (Abduction stress test)

18
Q

Which test would you use for the LCL

A

Varus Stress Test (Adduction stress test)

19
Q

What is a PCL test

A

Sag sign, Posterior drawer test (lots of tibia translation when done)