Lower Extremity

Question 1

common diagnoses for athletes with anterior knee pain

Answer 1

patellofemoral arthralgia and/or patellar tracking disorders

Question 2

elderly patients commonly present with?

Answer 2

osteoarthritis

Question 3

young athlete with tibial tuberosity pain

Answer 3

osgood schlatter’s disease

Question 4

if someone complains of instability in their knee?

Answer 4

chronic ACL damage

Question 5

if someone complains of painful knee locking?

Answer 5

meniscus tear

Question 6

hyperextension of knee

Answer 6

ACL tear or patellar dislocation

Question 7

hyperlfexion of knee

Answer 7

PCL tear and/or associated ACL tear

Question 8

sudden deceleration of the knee

Answer 8

ACL tear

Question 9

valgus force

Answer 9

medial collageral ligament tear

Question 10

valgus force with rotation

Answer 10

ACL, MCL and meniscus

Question 11

blow to a flexed knee

Answer 11

contusion, patellar fracture, PCL tear

Question 12

tests for ACL

Answer 12

lachman’s
anterior drawer
pivot shift

Question 13

meniscus tests

Answer 13

mcmurray’s

apley’s compression

Question 14

collateral lig. testing

Answer 14

varus and valgus stress test

Question 15

patellofemoral test

Answer 15

compression, stability and tracking

Question 16

ottawa knee rules for acute trauma

Answer 16

isolated tenderness at the patella
isolated tenderness of the fibular head
patient is unale to flex knee 90 degrees
patient is unable to bear weight immeidately after injury or take 4 steps

Question 17

ACL tear acute onset

Answer 17

sudden onset of knee pain following a hyperextnesion maneuver, sudden stopping or cutting, or contact injury with the knee being hit from teh side
may hear a pop
joint swelling appears quickly
unable to bear weight

Question 18

chronic presentation of ACL tear

Answer 18

past history of acute onset type with a gradual resolution of joint swelling and pain, with comlaint usually instability

Question 19

unhappy triad

Answer 19

ACL
meniscus
MCL tear

Question 20

radiographic signs of an unhappy triad

Answer 20

tibial spine fracture

Question 21

PCL tear

Answer 21

young athlete complains of knee pain following a blow to the front of his tibia with the knee in a flexed position or by forced hyperflexion
less common than ACL tear
posterior drawer test
sag sign

Question 22

how might someone describe a meniscus tear?

Answer 22

popping at the time of injury
pain
tightness
swelling within knee
locking up, catching, giving way of the knee
tenderness in the joint

Question 23

tests for meniscus tears

Answer 23

mcmurray’s

apley’s compression/distraction

Question 24

osgood schlatter’s disease

Answer 24

young athletes complain of pain and swelling at the tibial tuberosity
chronic fatigue injury due to repeated microtrauma to involving the patellar ligament insertion onto the tibial tuberosity

Question 25

osgood schlatter’s is due to?

Answer 25

repetitive activities

Question 26

DJD of the knee

Answer 26

stiffness and knee pain that is worse with prolonged sitting or walking
varus deformity may be present
decreased joint space predominantly involving the medial compartment with osteophytes, cystic changes, subchondral sclerosis and misalignment

Question 27

ostochondritis dessicans

Answer 27

young patient with insidious onet anterior knee pain with a limp

Question 28

what is OD?

Answer 28

a defect in the osteochondral bone and articular cartilage taht usually affect the lateral protion of the medial femoral condyle

Question 29

where does OD occur?

Answer 29

convex surfaces of bone
medial condyle of femur
capitellum
proximal surface of talus
head of 1st metatarsal
most common cause of intra-articular loose body

Question 30

FBI sign

Answer 30

mixture of fat and blood in a joint cavity following trauma

fat and blood enter the joint from the marrow space

Question 31

claudication

Answer 31

leg pain that occurs with walking and relief with rest

Question 32

neurogenic claudication

Answer 32

secondary to spinal stenosis with compression of nerves &/or blood supply to nerves causing leg symptoms that are related to exertion
often have LBP or radiation into the legs
walk or ride a bicycle in a flexed position

Question 33

vascular claudication

Answer 33

involves stenosis of peripheral blood vessels compromising the blood supply to the muscles
atherosclerotic blockages
diminished pulses
pallor
reduce capillayr refill
tropic skin changes and hair loss

Question 34

what is a major risk factor for vasuclar claudication

Answer 34

smoking

Question 35

intermittent claudication

Answer 35

older patient complains of leg pain after walking for a few minutes, must stop and rest before continuing
cramping, tightening or tiredness in the legs
resting is almost immediate relief

Question 36

neurogenic claudication s/s

Answer 36

back, thighs, callves
burning, cramping
aggravation:erect posture, ambulation, extension
relief: squatting, bending forward, sitting
leg pulses usually normal
walking down hil is worse
walking up hill is better

Question 37

vascular claudication s/s

Answer 37

buttocks, thigh, calves
cramping
aggravating: any leg exercise
releif: rest
pulses: BP decreased, pulses decreased/absent, bruits or murmurs may be present
skin changes present
better walking down hill
worse walking up hill

Question 38

what tests helps differentiate neurogenic and vascular claudication?

Answer 38

bicycle test