Sports Injuries (Albright) Flashcards
Name that disease:
- overuse syndrome
- “jumper’s knee” in adults
- MRI +
Patellar tendonitis
*image shows mucoid degenerative tissue from chronic repetitive injury
Name that disease:
- 10-15 year olds
- irritation of the apophysis, leading to palpable “bumps” and microfractures of the knee
- stops at maturity
Osgood Schlatters disease
*i have a hard time remembering this one so here’s my mnemonic: “bumpy knee is OSD and that is not osgood for me.”
persistent pain and localized tenderness are key features of this “overuse” type injury affecting the metatarsals, tibia, lumbar spine, hip and fibula
stress fracture
Since X-rays only identify about 50% of stress fracture cases, what follow up test may be necessary to confirm the diagnosis?
bone scan (technetium-99) or MRI
what’s the problem here?
hamstring injury (strain)
*strains involve muscle tendon units while sprains involve ligaments
Which of the following upper extremity problems is associated with the “apprehension sign”?
A. Sterno-clavicular dislocation
B. Glenohumeral dislocation
C. Acromio-clavicular separation
D. Rotator cuff tear
E. Subarcomial bursitis
B
Which of the following lower extremity problems is associated with the “apprehension sign”?
A. ACL rupture
B. Meniscus tear
C. PCL rupture
D. Chondral fracture
E. Patellar dislocation
E
damage to this ligament occurs by inversion and plantarflexion, such as the kind that occurs when you jump to get a rebound and land on someone’s foot
anterior talofibular ligament
*Anterior drawer test + during the golden period and after 4-5 days. A false - occurs during the painful period. This is a reasonably sensitive (86%) and specific (74%) test for ankle sprain.
this sprain is more severe than an anterior talofibular ligament sprain, and displays tenderness directly distal to the tip of the malleolus
calcaneofibular ligament
this test is useful for evaluation of a combined injury of both the anterior talofibular and the calcaneofibular ligaments
talar tilt test
All of the following are the Ottawa ankle rules’ indications for ankle x-ray EXCEPT:
A. Gross swelling
B. Tenderness in midfoot
C. Contusion
D. Can’t bear weight
E. Crepitus
C. This is bruising, and it is not indicative for x-ray.
What kind of sprain?
- minimal swelling
- tender above joint
- pain with outward twist
- can’t walk/push off
tib-fib sprain
most commonly injured knee ligament, generally caused by a valgus blow to the extended knee with no joint swelling (local only)
MCL
non-contact injury to this ligament often occurs in women who play soccer, due to twisting or changing direction on a slightly flexed knee
ACL
*she may hear a “pop” and have hemarthrosis 2-24 hours after injury - should aspirate this. Anterior drawer and Lachman’s test both +
What should you do if there’s swelling in the knee and ACL is suspected?
Get x-ray: swelling may be due to avulsion of the tibial eminence (bony attachment for ACL)
twisting injury that exhibits joint line tenderness, hemarthrosis (50%) and + McMurray’s, ie, painful pop
Meniscus tear
injury you’re likely to sustain if you are a hockey player or fall on an outstretched arm
A-C separation (acromioclavicular)
this injury occurs with anterior shoulder dislocation, in which part of the anterior inferior labrum detaches from the underlying glenoid (a labral tear); also commonly associated with a Hill-Sachs lesion
Bankart lesion
*watch this Ben-Stein-esque short video to clear up all your questions in approximately 1 minute.
a cortical depression in the head of the humerus that results from forceful impaction of the humeral head against the glenoid rim; occurs with anterior shoulder dislocation
Hill–Sachs lesion
*turns out it has nothing to do with golf whatsoever
A college basketball player hears a loud “pop” in her knee during a game and falls to the ground with severe pain. It subsides and is not tender, so she finishes the game. On exam the next day her knee is swollen and tender medially, with valgus laxity. She has a + Lachman’s test. Which of the following is most likely the diagnosis?
A. ACL tear
B. MCL tear
C. Medial meniscus tear
D. A triad injury involving all three
D
A 17 year old basketball player comes down from a rebound and lands on an opponent’s foot, causing his ankle to roll. He immediately experiences pain on the outside of his ankle. It is swollen with max tenderness at the talar neck and anterior fibula. What is the best test for diagnosing this injury?
A. X-ray
B. Talar tilt test
C. Anterior drawer test
D. Inversion/plantarflexion test
E. Bone scan
C
Hemarthrosis of the knee occurring in the first 2-24 hours after truama is frequently associated with all of the following EXCEPT:
A. ACL injury
B. MCL injury
C. Meniscus tear
D. Articular surface fracture
B
the least sensitive but most specific test for meniscus tear?
McMurray’s
Bonus: what is the most sensitive but least specific exam finding for meniscus tear?
*joint line tenderness
