Ortho Knee Flashcards

1
Q

MCL: what kind of stress with rotation?

A

vaLgus

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2
Q

LCL: what kind of stress with rotation?

A

vaRus

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3
Q

Tx for grade I & II MCL & LCL collateral ligament injuries

A

sprains & incomplete tears:

conservative: NSAIDS, PT

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4
Q

Grade III MCL & LCL collateral ligament injuries

A

complete tear: surgical repair

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5
Q

MC knee ligament injury

A

ACL

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6
Q

MOI ACL

A

noncontact pivoting injury (deceleration, hyperextension, internal rotation)

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7
Q

Presentation for ACL

A

pop & swelling –> hemarthrosis

inability to bear wt

does not actively extend knee

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8
Q

What is the most specific and sensitive test for ACL?

A

lachman’s test: 30 degree flexion of affected knee, push thigh downa nd inferior knee up

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9
Q

Segond Fx

A

avulsion of lateral tibial condyle w/ vaRus stress to the knee seen in ACL injury

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10
Q

Tx ACL

A

therapy vs surgical

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11
Q

O’Donoghues triad

A
  1. ACL injury
  2. medial collateral ligament
  3. medial meniscus
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12
Q

MC associated with dashboard injuries

(ant. force to proximal tibia with knees flexed)

A

PCL injuries

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13
Q

presentation for PCL injury

A

anterior bruising

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14
Q

PE for PCL

A

pivot shift test, post drawer test

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15
Q

Cause of meniscal tears

A

degenerative: squatting, twisting, compression or trauma w/femur rotation on tibia

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16
Q

MC meniscal tear

A

Medial

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17
Q

Presentation for Meniscal tear

A

locking, popping, “giving way”, effusion after activities

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18
Q

Best test for meniscal tear

A

McMurray’s sign: pop or click when tibia is externally and internally rotated

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19
Q

Apley test

A

meniscal tear: joint line tenderness

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20
Q

Tx for meniscal tear

A

NSAIDS, partial wt bearing until ortho f/up

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21
Q

MOI patellar fx

A

direct blow

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22
Q

presentation for patellar fx

A

pain swelling deformity

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23
Q

dx for patellar fx

A

X ray: sunrise view

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24
Q

nondisplaced patellar fx tx

A

knee immobilizer, leg cast x 6 weeks

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25
Q

displaced patellar fx

A

surgery

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26
Q

MOI for patellar/quadriceps tendon ruptures

A

forceful quadriceps contraction –> fall on a flexed knee walking up/down stairs

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27
Q

patellar and quadriceps tendon rupture MC in what population

A

males w/ hx of systemic disease (DM, gout, obesity, renal dz)

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28
Q

Presentation for patellar/quadriceps tendon ruptures

A

sharp proximal knee pain w/ambulation, inability to extend knee/straight leg raise

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29
Q

patella baja

A

quadriceps: defect above knee

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30
Q

patella alta

A

patellar: defect below knee

31
Q

Tx for patellar/quadriceps tendon

A

knee immobilizer, non or partial wt bearing, RICE

surgery within 7-10 days

32
Q

patellar D/L MOI

A

valgus stress after twisting injury (ballet dancer)

33
Q

PE patellar D/L

A

+ apprehension sign

34
Q

patellar D/L tx

A

closed reduction

35
Q

Knee D/L complication

A

severe limb threatening emergency!!!

36
Q

what artery should you be concerned about in a knee D/L?

A

popliteal artery rupture

perform arteriography

37
Q

knee D/L Tx

A

immediate ortho consult

38
Q

MOI femoral condyle Fx

A

axial loading: fall from height

39
Q

presentation for femoral condyle Fx

A

peroneal nerve injury (check 1st webspace) foot drop

popliteal artery injury

40
Q

Femoral condyle Fx Tx

A

immediate ortho consult

41
Q

Tibial plateau Fx

A

axial loading/rotation/direct trauma

MC in children in MVA

42
Q

tibial plateau Fx complication

A

post degenerative arthritis

43
Q

If tibial plateu Fx is displaced, what should you check for?

A

peroneal nerve injury (foot drop)

44
Q

osteochondritis of the patellar tendon @ tibial tuberosity from overuse

A

osgood schlatter disease

45
Q

MCC of chronic knee pain in young, active individuals

A

osgood schlatter disease

46
Q

MC in 10-15 y/o athletes w/ “growth spurts”

A

osgood schlatter disease

47
Q

Typical presentation for osgood schlatter disease

A

activity related knee pain/swelling

painful lump below knee, tenderness to anterior tibial tubercle

48
Q

Dx test of choice for osgood schlatter disease

A

X ray: prominence or heterotrophic ossification @ tibial tuberosity

49
Q

Tx for osgood schlatter disease

A

RICE, NSAIDS, quadriceps stretching, resolves w/time

50
Q

Typical presentation for Bakers cyst

A

popliteal mass, knee effusion

51
Q

ruptured popliteal cyst mimcs what

A

DVT

52
Q

Dx for popliteal cyst

A

US

53
Q

Bakers cyst Tx

A

ice, assisted wt bearing, NSAIDS, CS injection

54
Q

idiopathic softening/fissuring of patellar articular cartilage

MC in runners

A

patellofemoral syndrome (chondromalacia)

55
Q

PE for patellofemoral syndrome (chondromalacia)

A

+ apprehension sign

56
Q

Tx for patellofemoral syndrome (chondromalacia)

A

NSAIDS, rest, rehab

57
Q

inflammation of IT band bursa

A

IT band syndrome

58
Q

MCC of knee pain in runners

A

IT band syndrome

59
Q

Presentation of IT band syndrome

A

lateral knee pain during onset of running, then resolves

worse with climbing stairs or running downhill

60
Q

Ober test

A

pain/resistance to adduction

IT band syndrome

61
Q

+ lateral condyle tenderness

A

IT band syndrome

62
Q

anterior knee D/L is caused by..

A

hyoerextension

63
Q

Knee instability in multiple directions

A

tibiofemoral dislocation (anterior knee dislocation)

64
Q

dimple sign with posterolateral dislocation

A

anterior knee D/L

65
Q

posterior knee D/L is caused by….

A

direct blow to anterior tibia with knee flexed

66
Q

heel pain worse after period of rest that gets better with movement throughout the day

A

plantar fasciitis

67
Q

pain that increases with dorsiflexion of the foot and usually worse after period of rest

A

plantar fasciitis

68
Q

Dx for plantar fasciitis

A

X rays may show flat foot deformity or heel spur

69
Q

Tx plantar fasciitis

A

stretching exercises for plantar fascia and calf muscles

avoid flat shoes and barefoot walking

NSAIDS

70
Q

absence of plantar flexion w/ squeezing of calf

A

achilles tendon rupture

71
Q

Tx for achilles tendon

A

Splint in plantar flexion, keep nonweight bearing, ortho follow up q

72
Q

Galeazzi Test

A

identifies developmental hip dysplasia due to femoral shortening

Knees NOT level = positive test

73
Q
A