MCL injury Flashcards
hx
34 yr old female one day after slipping while hill walking, felt pop inside knee, could walk down the mountain but felt some pain, knee stiff and a bit swollen this morning
look
antalgic gait
feel
tenderness
proximal or distal to joint line for a MCL injury
joint line tenderness = meniscus injury
active and passive movement
full ROM left knee
resisted movement
nil of note
special tests
medial and lateral collateral ligaments tested with values and varus stress test
cruciate ligamnet test post/ ant drawers test
meniscus exam McMurrays test may be too painful to do
DDx
MCL injury
ACL rupture
cartilage/ meniscus injury
why is MCL injury likely?
typical hx, full ROM, pos valgus stress test, tender above or below joint line
why is ACL rupture unlikely ?
immediate effusion/ haemarthrosis
ant drawer test, lachmann test neg
why is cartilage or meniscus injury unlikely?
no symptoms within knee joint
no locking
investigations
not necessary if mild ligament sprain
xray knee outrule fracture
MRI knee grade 1 vs grade 3 MCL ruptures
non op tx
rest ice elevation
analgesia
physio
Don Joy brace
op tx
grade 3 complete MCL ruptures
