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msk > soft tissue knee injuries > Flashcards

soft tissue knee injuries Flashcards

1
Q

how do meniscal tears usually occur

A
  • usually sporting injury in younger patients or getting up from squatting position
  • atraumatic spontaneous degenerate tears in old patients
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2
Q

symptoms of meniscal tear

A

pain and tenderness localized to joint line

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3
Q

what are the four types of meniscal tears

A
  • longitudinal tears
  • radial tears
  • bucket handle tear
  • parrot beak tear
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4
Q

which type of tear wont heal

A

radial

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5
Q

what should you consider for acute traumatic peripheral meniscal tears in young people

A

arthroscopic meniscal repair

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6
Q

when would you consider arthroscopic meniscectomy

A

for irreparable tears with recurrent pain, effusion or mechanical symptoms which fail to settle

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7
Q

what type of tear does an acute locked knee signify

A

displaced bucket handle meniscal tear

urgent surgery required

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8
Q

what causes degenerate tears

A

meniscus weakens with age and can tear spontaneously

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9
Q

what type of stress does MCL resist

A

valgus stress

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10
Q

what type of stress does LCL resist

A

varus stress

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11
Q

what does ACL resist

A

anterior subluxation of the tibia and internal rotation of the tibia in extension

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12
Q

what does PCL resist

A

posterior subluxation of the tibia

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13
Q

what are the three grades of knee ligament injuries

A

grade 1 - sprain - tear some fibres but macroscopic structure intact
grade 2 - partial tear
grade 3 - complete tear

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14
Q

what can MCL rupture lead to

A

valgus instability

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15
Q

what can ACL rupture lead to

A

rotatory instability

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16
Q

what can PCL rupture lead to

A

recurrent hyperextension or instability descending stairs

17
Q

treatment for MCL injury

A
  • brace
  • early motion
  • physio
18
Q

requirement for ACL rupture stabilization

A

time and physio

19
Q

when is surgery considered in ACL rupture

A

rotatory instability not responding to physio

20
Q

how long is the recovery for ACL reconstruction

A

3/12 to 1 year rehab

21
Q

how does LCL injury usually happen

A

varus and hyperextension

22
Q

how do PCL ruptures happen

A

direct blow to anterior tibia or hyperextension injury

23
Q

cause of patellar dislocation

A

rapid turn or direct blow

24
Q

causes of patellofemoral pain syndrome

A
  • muscle imbalance
  • tightness of lateral tissues
  • bony malalignment
  • flat feet
25
Q

cause of extensor mechanism rupture

A

fall onto flexed knee with quads contraction - rupture quads or patellar tendon

26
Q

what is osteochondritis dissecans

A

an area of the surface of the knee loses its blood supply and cartilage +/- bone can fragment off

27
Q

cause of bone bruising/bone marrow oedema

A

impaction to articular surface leads to microscopic fracture of trabecular bone with bleeding and inflammation

28
Q

cause of loose bodies

A
  • trauma
  • OCD
  • joint degeneration
29
Q

what can happen to loose bodies in the joint

A

they can grow overtime getting nutrition from synovial fluid and may cause painful locking or catching

some can stick to synovium or fat pad

30
Q

which bone is commonly misdiagnosed as a loose body

A

the fabella

31
Q

what do you do when the pain or swelling is worse than examination and x-rays

A

MRI to look for unusual pathology

31
Q

what do you do when the pain or swelling is worse than examination and x-rays

A

MRI to look for unusual pathology

32
Q

whats the diagnosis:

football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability

A

ACL rupture

33
Q

diagnosis?:

getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain and catching +/- locking

A

meniscal tear

msk (45 decks)

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