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MSK > Disorders Of The Knee > Flashcards

Disorders Of The Knee Flashcards

1
Q

What is septic arthritis?

A

Invasion of joint space by microorganism

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2
Q

What microorganism most commonly causes septic arthritis?
What its gram stain?

A

Staphylococcus aureus
Gram positive cocci

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3
Q

Risk factors of septic arthritis

A

Extremes of age
RA
Diabetes mellitus
Immunosuppression
IV drug use

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4
Q

What can cause septic arthritis?

A

Recent surgery - prosthetic joints
Knee effusion secondary to bacterial infection
Articular cartilage damage

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5
Q

Symptoms of septic arthritis and what to examine for

A
  • fever
  • pain
  • reduced ROM

Examine for:
- erythema
- swelling
- warmth
- tenderness
- ROM

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6
Q

What needs to be done if septic arthritis is suspected?

A
  • Aspiration of joint - use ultrasound to help
  • Send aspirate for urgent microscope, culture + sensitivities
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7
Q

Risk factors for knee osteoarthritis

A

Age
Sex female > male
Weight
Post traumatic
Genetics

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8
Q

Treatment of osteoarthritis

A

Weight loss
Strengthening exercises
Surgery
NSAIDs

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9
Q

How is sclerosis seen on an x ray?

A

Increased whiteness as bone is more dense

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10
Q

What is Osgood-Schlatter’s disease?

A

Inflammation of the apophysis of patella ligament into tibial tuberosity

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11
Q

Treatment of Osgood-Schlatter’s disease

A

Resolves with rest + ice

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12
Q

What bursae is inflamed in housemaid’s knee?

A

Pre-patellar bursitis
Leaning forward on knee

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13
Q

What bursa is inflated in clergyman’s knee?

A

Intra-patellar bursitis
Kneeling

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14
Q

What bursa is inflamed in Baker’s/popliteal cyst?

A

Semimembranosus bursa

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15
Q

What is another name for semimembranosus bursitis?

A

Baker’s/popliteal cyst

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16
Q

What is another name for pre-patellar bursitis?

A

Housemaid’s knee

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17
Q

What is another name for infra-patellar bursitis?

A

Clergyman’s knee

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18
Q

What is fluid inside a joint called?

A

Effusion

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19
Q

What is fluid outside a joint called?

A

Soft tissue haematoma

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20
Q

When is a knee effusion normal?

A

Never normal

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21
Q

What are the types of knee effusion and what is suspected until proven otherwise?

A

Haemarthrosis - blood in joint
- ACL injury until proven otherwise

Lipo-haemarthrosis- fat and blood in joint
- fracture until proven otherwise

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22
Q

What is haemarthrosis in the knee thought to be caused by until proven otherwise?

A

ACL injury

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23
Q

What is lipo-haemarthrosis in the knee thought to be caused by until proven otherwise?

A

Fracture

24
Q

Causes of knee swelling

A

VITAMIN C+D
Vascular - haemarthosis
Inflammatory - bursitis
Trauma - meniscal tear&raquo_space; effusion
Autoimmune - RA
Metabolic - gout
Iatrogenic - infected prosthetic joint
Neoplasia - rare
Cancer - rare
Degernative - OA

25
Q

How many ligaments are ruptured in a knee joint dislocation?

A

3/4

26
Q

Cause of knee joint dislocation

A

High energy trauma

27
Q

Mechanism of collateral ligament injury

A

Contact/direct blow e.g. sport

28
Q

What type of strain is there if the medial collateral ligament is injured?

A

Valgus strain }{

29
Q

What type of strain is there if the lateral collateral ligament is injured?

A

Varus strain {}

30
Q

What is the unhappy triad?

A

ACL
Medial collateral ligament
Medial meniscus

31
Q

Treatment of collateral ligament injury

A

Brace + rehabilitation
Surgical repair + reconstruction

32
Q

What crucial ligament is more common to injury?

A

ACL

33
Q

Mechanism of ACL injury

A

Non contact - landing or direction change

34
Q

Mechanism of PCL injury

A

Contact - falls + hyperextension

35
Q

What tests can be used to examine the cruciate ligaments

A

Lachman’s test
Anterior and posterior drawer test

36
Q

What do normal menisci look like on an MRI?

A

Black triangle

37
Q

Mechanism of meniscal injures

A

Twisting injury

38
Q

Symptoms of meniscal injuries

A

Catching
Jamming
Locking - unable to straighten knee
Localised pain
Swelling

39
Q

Treatment of traumatic meniscal injury

A

Meniscal repair
Menisectomy

40
Q

Treatment of degenerative meniscal injury

A

Leave alone
Rehabilitate

41
Q

What helps to prevent patella dislocation?

A

Vastus medialis obliquus

42
Q

Function of VMO

A

Stabilise patella in trochlea groove
Control tracking in flexion + extension
Prevents patella dislocation

43
Q

Mechanism of patella dislocation

A

Twisting action in slight flexion
Trauma
Direct blow to knee

44
Q

Predisposition of patella dislocation

A

Previous dislocation
Long patellar ligament
Shallow trochanter grove
Ligament laxity
Weakness of Vastus medialis obliquus

45
Q

Treatment of patella dislocation

A

Reduce + immobilise
Soft tissue reconstruction

46
Q

How to check for a patella fracture

A

Ask patient to raise a straight leg
Inability to is indicative of a patella fracture

47
Q

Inability to raise straight leg is indicative to what?

A

Patella fracture

48
Q

What risk if there after a patella fracture?

A

Post traumatic OA

49
Q

Treatment of displaced patella fracture

A

Reduce + fix

50
Q

Treatment of undisplaced patella fracture

A

Splint + protect

51
Q

Sites of femoral shaft fractures

A

Proximal
Mid shaft
Supracondylar

52
Q

Risk after femoral shaft fracture

A

Hypovolaemic shock

53
Q

Mechanism of femoral shaft fracture

A

High energy injury - RTA + falls from height
Significant force needed

54
Q

Treatment of femoral shaft fracture

A

Traction splint - stabilises bone
Surgical fixture

55
Q

Mechanism of distal femoral fracture

A

Young - high energy sport
Older - fall from standing

56
Q

What is at risk of damage in a distal femoral fracture?

A

Popliteal artery

MSK (25 decks)

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