QUIZ 3 Flashcards
patellofemoral pain syndrome is most commonly associated with which of the following?
a. increase in pain with walking downstairs
b. presence of pain at rest
c. presence of sharp, localized posterior knee pain
d. activities that create high compressive loads
d. activities that create high compressive loads
you are a team chiropractor and an athlete under your supervisor has sustained an acute injury to their knee during a game. You evaluate the patient on the field by performing a quick regional examination. You want to determine the extent of the injury and whether you should initiate treatment or if X-rays are first required. According to the Ottawa Knee Rules, plain film radiographs are indicated if which of the following are true:
a. The patient is > 18 year of age
b. There is suspicion of major meniscal pathology
c. There is isolated tenderness at the
d. There is suspicion of major ACL pathology
c. There is isolated tenderness at the patella
Following an injury to the knee, an MRI is indicated when:
a. There is isolated tenderness at the fibular head
b. The patient is > 55 year of age
c. The patient is unable to bear weight immediately after injury or take 4 steps in the emergency department
d. The patient is unresponsive to conservative care
d. The patient is unresponsive to conservative care
A 13 year old by who is an avid soccer player presents with a complaint of right sided knee pain. The pain is worse with activity. Rest is palliative. The pain has been present intermittently for several months; this is the first time medical evaluation has been sought. Physical examination reveals tenderness and swelling at the tibial tuberosity. Knee joint examination is normal but the chief complaint is reproduced by extending the knee against resistance. Based on the clinical picture provided, this patient is MOST LIKELY suffering from:
a. Osgood-Schlatter’s Disease
b. Condromalacia Patella
c. Avulsion fracture of tibial tuberosity
d. Myositis Ossificans
a. Osgood-Schlatter’s Disease
Regarding THessaly’s Test, which of the following is CORRECT?
a. Knee pain elicited during the test rules out the possibility of an MCL tear.
b. Knee pain elicited during the test rules out the possibility of an ACL tear.
c. A negative test definitely rules out the possibility that a patient has a torn meniscus
d. You are more likely to elicit a positive finding in 20° of knee flexion that at 5° of flexion
d. You are more likely to elicit a positive finding in 20° of knee flexion that at 5° of flexion
The classic “terrible triad” (O’Donoghue’s Triad) involves a valgus stress to the knee with resultant acute injury to the;
a. MCL, LCL and lateral meniscus
b. MCL, LCL and medial meniscus
c. MCL, ACL and medial meniscus
d. MCL, PCL and medial meniscus
c. MCL, ACL and medial meniscus
A 14 year old patient complains of knee pain that is associated with running. The pain began insidiously one-week ago. He has no prior history of knee pain or trauma. He notices that he pain is worse when running uphill, going upstairs and with prolonged sitting while he is in class. Noble’s Compression Test is negative and the pain is reproduced when performing Clarke’s Test. Based on the clinical picture provided, this patient is MOST LIKELY suffering from:
a. Patellofemoral Pain Syndrome
b. Iliotibial Band Friction Syndrome
c. Patella Alta
d. Chondromalacia Patella
a. Patellofemoral Pain Syndrome
A patient presents with a complaint of medial knee pain and clicking/snapping that he notices mostly while riding his bike and while rowing on a stationary rowing machine. There is tenderness to palpation medial to the patella with the knee in flexion. McMurray’s and Clarke’s Tests are negative. Knee Valgus and Varus Stress Tests are negative. Radiographs of the knee are unremarkable. Based on the clinical picture provided, this patient is MOST LIKELY suffering from:
a. Medial meniscus tear
b. Medial collateral ligament (MCL) Sprain
c. Condromallacia Patella
d. Inflamed mediopatella plica.
d. Inflamed mediopatella plica
A patient presents with local pain, tenderness and swelling over the anteromedial, proximal tibia below the joint line. The pain is intensified when walking and when traveling upstairs but the patient denies experiencing a locking sensation with ambulation. Valgus stress at 30 degrees of knee flexion does NOT increase the pain. This patient is MOST LIKELY suffering from:
a. Pes Anserine Bursitis
b. Medial Meniscus Tear
c. Popliteus Tenosynovitits
d. MCL Bursitis
a. Pes Anserine Bursitis
A soccer player running after the ball during a game stops suddenly to change directions. He immediately notices a “popping” sensation in his knee accompanied by intense pain in the anterior aspect of his knee. He is unable to ambulate. Approximately one hour after the injury he presents to your office for evaluation. However, you are unable to gain accurate information from the physical examination of the knee due to painful acute hemearthrosis. Based on the clinical picture provided, what is the MOST LIKELY diagnosis?
a. Lateral Collateral Ligament sprain
b. Patellar Tendonitis
c. Anterior Collateral Ligament tear
d. Lateral meniscus tear
c. Anterior Collateral Ligament tear
A recreational runner presents to your office with a complaint of right knee pain. She says the pain is worse when going downhill but is not bothersome when running uphill. The pain typically feels more superficial, on the outside of the knee but occasionally, when it is aggravated, the pain feels as though it is deeper in the knee. Rest is palliative Palpation of the knee elicits pain anterior to the LCL attachment at he femur. Resisted internal rotation of the knee increases the pain, all other ROM are normal and pain free. Varus stress (-), Noble’s (-). McMurrays (-). Based on the clinical picture provided, what is the MOST LIKELY diagnosis?
a. ITB Friction Syndrome
b. LCL Sprain
c. Lateral Meniscus Tear
d. Popliteus Tenosynovitis
d. Popliteus Tenosynovitis
A patient presents with lateral knee pain, when asked to locate the pain, she points to an area 2 cm proximal to the lateral joint line. She explains the pain is worse when she flexes and extends her knee. There is tenderness to palpation at the area of the chief complaint but nowhere else along the knee. Ober’s test is (+) Varus, Valgus and Drawers Tests are (-). Based on the clinical picture provided, what is the MOST LIKELY diagnosis?
a. ITB Friction Syndrome
b. LCL Sprain
c. Lateral Meniscus Tear
d. Popliteus Tenosynovitis
a. ITB Friction Syndrome
Which statement is the CORRECT characterization of Patellofemoral Pain Syndrome?
a. It is primarily a soft tissue disorder
b. it is a disorder involving damage to the underlying patellar cartilage
c. it is often caused by Chondromalacia Patella
d. it most often presents as posterior knee pain
a. It is primarily a soft tissue disorder
Which signs and/or symptoms are pathognomonic of Osgood-Schlatter’s Disease?
a. insidious onset of pain at the tibial tuberosity in a geriatri patient
b. localized pain at the tibial tuberosity that is relived by rest
c. localized pain, tenderness & swelling at the tibial tuberosity
d. ligamentous laxity and pain about the tibial tuberosity
c. localized pain, tenderness & swelling at the tibial tuberosity
Which of the following is TRUE regarding meniscus tears?
a. lateral meniscus is smaller than the medial which predisposes it to injury more often
b. vertical, stable tears along the peripheral aspect of the meniscus often heal in young patients
c. meniscus tears are stable and will not progress but also cannot heal
d. Chiropractic manipulative therapy is not helpful in reducing symptoms
b. vertical, stable tears along the peripheral aspect of the meniscus often heal in young patients
