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musculoskeletal > Knee Conditions > Flashcards

Knee Conditions Flashcards

1
Q

who usually presents with a patellar dislocation

A

teenage females

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2
Q

what can cause patellar dislocation

A

direct blow
sudden quadriceps contraction with a flexing knee

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3
Q

which way does a patella dislocate

A

ALWAYS laterally

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4
Q

give some risk factors for patellar dislocation

A

hypermobility
increased Q angle
high riding patella

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5
Q

clinical signs of patellar dislocation

A

pain medially, effusion
positive patellar apprehension test

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6
Q

XR of patellar dislocation

A

lipo-haemarthrosis

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7
Q

management of patellar dislocation

A

reduction with knee extension
physiotherapy

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8
Q

complication of patellar dislocation

A

osteochondral fracture

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9
Q

lateral collateral ligament injury + peroneal nerve injury

A

complete knee dislocation that has spontaneously reduced

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10
Q

clinical presentation of complete knee dislocation

A

pain and instability of the knee

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11
Q

immediate management of complete knee dislocation

A

emergency reduction under sedation

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12
Q

when might you require surgical reduction of a complete knee dislocation

A

if medial femoral condyle button-holed through the medial capsule

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13
Q

definitive management of complete knee dislocation

A

sequential ligamentous repair

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14
Q

clinical signs of a patellar fracture

A
  • Palpable patellar defect
  • Significant hemarthrosis
  • Unable to preform straight leg raise
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15
Q

conservative management of patellar fracture

A

knee immobilisation in extension

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16
Q

operative management of patellar fracture

A

ORIF

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17
Q

what is a bakers cyst

A

ganglion cyst in the popliteal fossa

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18
Q

what do bakers cyst usually arise in conjunction to

A

OA of the knee

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19
Q

clinical presentation of bakers cyst

A

general fullness in the popliteal fossa
soft and non-tender
painful rupture

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20
Q

clinical presentation of patellofemoral dysfunction

A

anterior knee pain, worse going downhill
grinding/clicking sensation

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21
Q

how do you investigate bone bruising

A

MRI

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22
Q

what do most tibial plateau fractures affect

A

lateral condyle

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23
Q

what is used to classify tibial plateau fractures

A

schatzer classification

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24
Q

complication of a bumper injury

A

damage to the common fibular nerve

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25
Q

name a high risk complication of tibial plateau fracture

A

compartment syndrome

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26
Q

what are loose bodies in a joint

A

small fragments of cartilage or bone that can move freely around in joint fluid

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27
Q

what can cause loose bodies to form

A

trauma, osteochondritis dissecans, joint degeneration

28
Q

clinical presentation of a loose body in the joint

A

History of mobile lump or sharp occasional pain and locking/catching suggestive of loose body

29
Q

what can commonly be misdiagnosed as a loose body of the knee

A

fabella

30
Q

what is a fabella

A

an accessory ossicle in the lateral head of gastrocnemius

31
Q

management of loose bodies

A

arthroscopic removal

32
Q

mechanism of injury in a young patient with a meniscal tear

A

twisting force sporting injury

33
Q

mechanism of injury in an older patient with a meniscal tear

A

atraumatic spontaneous degenerate tears

34
Q

what is the most common type of meniscal tear

A

medial

35
Q

what can meniscal tears be associated with

A

ACL ruptures

36
Q

clinical presentation of a meniscal tear

A

pain localised to the joint line (lateral or medial)
catching or locking sensation

37
Q

acute locked knee

A

displaced bucket handle meniscal tear

38
Q

clinical sign of meniscal tear

A

positive meniscal provocation test
inflammatory effusion

39
Q

investigation of meniscal tear

A

MRI

40
Q

management of meniscal tear in younger patient

A

arthroscopic meniscal repair

41
Q

management of degenerative meniscal tears

A

RICE
analgesia
physio

42
Q

mechanism of action of a knee ligament injury

A

rotational movement of the knee joint

43
Q

how can we classify knee ligament injuries

A

Grade 1: sprain
grade 2: partial tear
grade 3: complete tear

44
Q

complication of MCL tear

A

valgus instability

45
Q

complication of ACL rupture

A

rotatory instability

46
Q

complication of a PCL rupture

A

recurrent hyperextension or instability descending stairs

47
Q

mechanism of a MCL injury

A

valgus stress with possible external rotation

48
Q

clinical presentation of MCL injury

A

knee swelling with ecchymosis + pain
medial joint line tenderness
medial joint laxity and pain on valgus stress

49
Q

management of an acute MCL tear

A

hinged knee brace

50
Q

management of a chronic MCL instability

A

MCL tightening

51
Q

what is the most common injured knee ligament

A

ACL

52
Q

mechanism of ACL injury

A

twisting sports injury

53
Q

who is more likely to present with ACL injury

A

females

54
Q

clinical presentation of ACL injury

A

audible pop followed by deep knee pain and swelling within the hour
excessive anterior translation of the tibia on anterior drawer test

55
Q

investigation of ACL injury

A

joint aspiration shows hemarthrosis
MRI to confirm

56
Q

complication of ACL injury

A

arthritis

57
Q

when is ACL reconstruction indicated

A

rotatory instability not responding to physio

58
Q

when does an LCL injury commonly occur

A

in combination with other ligament injuries

59
Q

mechanism of injury of LCL injury

A

varus stress and hyperextension

60
Q

clinical presentation of LCL injury

A

knee swelling + ecchymosis, pain, deformity
lateral joint line tenderness
lateral joint laxity

61
Q

management of LCL injury

A

complete rupture needs urgent repair

62
Q

complications of LCL injury

A

common fibular nerve palsy
early OA of the knee

63
Q

mechanism of injury of a PCL injury

A

a direct blow to the anterior tibia

64
Q

clinical presentation of PCL injury

A

popliteal knee pain and bruising
positive posterior drawer test and sag sign

65
Q

who usually presents with an extensor mechanism rupture

A

middle age population who play running or jumping sports

66
Q

clinical sign of extensor mechanism rupture

A

unable to do a straight leg raise

musculoskeletal (30 decks)

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