Lower Limb Soft Tissue Injury

Question 1

What is the most common cause of posterior heel pain?

Answer 1

Achilles tendon disorders

Presentations include tendinopathy (tenditis), partial tear, complete tear (or rupture).

Question 2

What are two risk factors for achilles tendon disorders?

Answer 2

1. quinolone use (e.g. ciprofloxacin)
2. hypercholesterolaemia (predisposes to tendon xanthomas)

Question 3

What are the features of achilles tendinopathy (tendinitis)?

Answer 3

• gradual onset, posterior heel pain
• worse following activing
• morning pain and stiffness

Question 4

What is the management for achilles tendinopathy (tendinitis)?

Answer 4

Typically supportive:
- simple analgesia
- reduce precipitating actvities

Question 5

When should achilles tendon rupture be suspected?

Answer 5

Person describes the following whilst playing sport:
- audible ‘pop’ in ankle
- sudden onset significant pain in calf or ankle
- inability to walk or continue sport

Question 6

What is Simmond’s triad?

Answer 6

Used as examination guide to exclude achilles tendon rupture, includes:
1. abnormal angle of declination
2. greater dorsiflexion of injured foot
3. squeeze calf, foot stays in neutral position

Question 7

Imaging modality of choice in achilles tendon rupture?

Answer 7

Ultrasound

Question 8

What is iliotibial band syndrome?

Answer 8

A common cause of lateral knee pain in runners
Features include tenderness 2-3cm above lateral joint line.
Management includes acitivity modification and physiotherapy.

Question 9

What is the most commonly injured knee ligament?

Answer 9

Anterior cruciate ligament

Question 10

Common mechanisms of injury damaging anterior cruciate ligament?

Answer 10

• lateral blow to the knee
• skiing
• sudden twisitng
• landing awkwardly

Question 11

What is the typical mechanism of injury for meniscal tears?

Answer 11

Twisting injury

Question 12

What is Chondromalacia Patellae?

Answer 12

• softening of cartilage of patella
• common in teenage girls
• anterior knee pain on walking up/down stairs

Question 13

What is Osgood-Schlatter disease?

Answer 13

• commonly seen in sporty teenagers
• pain, tenderness and swelling over the tibial tuberosity

Question 14

What is Osteochondritis dissecans?

Answer 14

• pain after exercise
• intermittent swelling and locking of the knee

Question 16

What is patellar subluxation?

Answer 16

• medial knee pain
• due to subluxation of patella
• knee may give way

Question 17

What is patellar tendonitis?

Answer 17

• more common in athletic teenage boys
• chronic anterior knee pain, worse after running
• tender below patella on examination