Soft Tissue Injuries of Knee Flashcards

1
Q

how is diagnosis made

A

detailed history, clinical exam and subsequent investigation

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2
Q

how do meniscal injuries usually occur

A

twisting force on a loaded knee (turning at football)

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3
Q

where is the pain localised to following a meniscal injury

A

medial (majority) or lateral joint line

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4
Q

what follows a meniscal injury the following day

A

effusion

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5
Q

what do patients usually complain of following a meniscal injury

A

pain and then usually has mechanical symptoms

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6
Q

what are some mechanical symptoms following a meniscal injury

A
  • catching sensation
  • locking (difficulty straightening the knee with around a 15 degree block to full extension)
  • patient may feel their knee is going to give way if a loose meniscal fragment is caught in the knee when walking
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7
Q

what causes ‘locking’

A

significantly torn meniscus flipping over and becoming stuck in the joints line

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8
Q

what is a clinical sign associated with meniscal tear

A

‘locking’

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9
Q

what is ‘pseudo-locking’

A

patient describes that their knee can ‘become stuck’ with temporary difficulty in straightening the knee particularly when rising from sitting to standing and this will either spontaneously resolve or patient has a trick manoeuvre that can resolve it

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10
Q

what conditions can cause pseudo-locking

A

arthritis

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11
Q

how can locking and pseudo-locking be told apart

A

careful history and exam

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12
Q

is pseudo-locking a sign of meniscal injury

A

no

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13
Q

what causes ACL rupture

A
  • higher rotational force
  • turning upper body laterally on a planted foot (internal rotation force on tibia)
  • rugby, skiing, high impact sport
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14
Q

what might be felt or heard following ACL rupture

A

a pop

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15
Q

what can patients develop after an ACL rupture

A

haemarthrosis (effusion due to bleeding in the joint from the vascular supply within the ACL)

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16
Q

how long does it tend to develop a haemarthrosis

A

usually within an hour

17
Q

what can patients complain of chronically

A

rotatory instability with their knee giving way when turning on a planted foot (due to excessive internal rotation of tibia)

18
Q

what can valgus stress injuries (e.g rugby tackle to the side) tear

A

MCL and high forces will also potentially damage the ACL and risk lateral tibial plateau fracture

19
Q

what causes a ruptured PCL

A

a direct blow to the tibia with the knee flexed (e.g a motorcycle crash) or hyperextension

20
Q

what causes a LCL rupture

A

varus stress injury with or without PCL damage

21
Q

why is it good to wait 2-7 days to examine the knee after any of these injuries

A

pain and apprehension can limit examination findings

22
Q

when is an MRI used

A

if the injury is thought to be significant, has a suspicious history or there are multiple ligaments involved it can help delineate the extent of the injury