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Injuries of the Lower Limb Flashcards

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1
Q

What are the three types of knee joint injuries?

A

Meniscal, ligament and articular cartilage injuries

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2
Q

What are the 6 mechanisms of injury for traumatic knee injuries?

A

Hyperflexion, hyperextension, varus (outwards), valgus (inwards), rotation and combination

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3
Q

What is the history of meniscal injuries?

A

Twisting injury in weight bearing, acute pain, catching, clicking, locking, giving way

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4
Q

What is the mechanism of injury for meniscal injuries?

A

Detachment of the meniscus, longitudinal/transverse rupture

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5
Q

What are the clinical findings of meniscal injuries?

A

Swelling, limited ROM, joint line tenderness, pain with squatting, positive McMurray’s test

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6
Q

What investigations are used for meniscal injuries?

A

MRI and ultrasound

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7
Q

What is the treatment for meniscal injuries?

A

Arthroscopy - tear is removed or repaired

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8
Q

What condition is a risk associated with meniscal injuries?

A

Osteoarthritis

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9
Q

What are four knee ligaments that can be injured?

A

Anterior cruciate, posterior cruciate, medial collateral, lateral collateral

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10
Q

What is the mechanism of injury for ACL injuries?

A

Twisting, hyperextension, weight bearing

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11
Q

What is the history of ACL injuries?

A

Injury mechanism, hear/feel snap/crack, pain, loss of function, swelling

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12
Q

What are the clinical findings of ACL injuries?

A

Specific tests - Lachman’s, pivot-shift

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13
Q

What investigations are used for ACL injuries?

A

X-ray, MRI, CT scan

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14
Q

What are the treatments and outcomes of ACL injuries?

A

Surgery vs. conservative; risk of osteoarthritis and recurrence

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15
Q

What is the mechanism of injury for PCL injuries?

A

Direct blow to anterior tibia, hyperextension

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16
Q

What is the history of PCL injuries?

A

Injury mechanism, pain, swelling, often presents late

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17
Q

What is considered in the examination of PCL injuries?

A

Swelling, posterior sag of tibia, posterior drawer test

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18
Q

What investigations are used for PCL injuries?

A

X-ray, MRI

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19
Q

What are the treatments for PCL injuries?

A

Usually conservative, surgery if unstable

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20
Q

What are the outcomes of PCL injuries?

A

Usually able to return to normal activity, always be aware of posterolateral corner injury

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21
Q

What is the mechanism of injury for valgus injuries?

A

Impact against the outside of the knee, pushing it inwards (lateral force)

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22
Q

What is the mechanism of injury for varus injuries?

A

Impact against the inside of the knee, pushing it outwards (medial force)

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23
Q

What is the mechanism of injury for medial collateral ligament (MCL) injuries?

A

Valgus stress

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24
Q

What is considered in the examination of MCL injuries?

A

Pain/tenderness medially, +/- swelling, gapping with valgus stress, grade 1/2/3

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25
What investigations are used for MCL injuries?
X-ray, MRI
26
What are the treatments for MCL injuries?
Grade 1: Conservative, ROM brace | Grade 2: Often conservative, sometimes surgery
27
What is the mechanism of injury for lateral collateral ligament (LCL) injuries?
Varus stress
28
What is considered in the examination of LCL injuries?
Pain laterally, gapping laterally with varus stress, grade 1/2/3
29
What investigation is used for LCL injuries?
MRI
30
What are the treatments for LCL injuries?
Grade 1/2: Conservative | Grade 3: Surgery
31
The mechanism and clinical findings of articular cartilage injuries are similar to what other type of knee injury?
Meniscal
32
What is the treatment for articular cartilage injuries?
Arthroscopic debridement
33
What is a type of articular cartilage injury?
Osteochondritis dissecans
34
What is osteochondritis dissecans?
Death of articular cartilage and bone fragment, release of bone & articular cartilage into the joint
35
When does osteochondritis dissecans usually occur?
Adolescence
36
What are the symptoms of osteochondritis dissecans?
Pain, swelling, catching, locking
37
What is the anatomy of anterior knee pain?
Quadriceps mechanism, Q angle, patella mechanics
38
What are the causes of anterior knee pain?
Retropatella pain syndrome, patella tendinosis, traction apophysistis
39
What is the mechanism of injury for retropatella pain syndrome?
VMO, lateral structures, feet, exercise
40
What is the history of retropatella pain syndrome?
Pain with activity, prolonged sitting, pain up/down stairs
41
What is considered in the examination of retropatella pain syndrome?
Laterally sitting patella, tight ITB/quads, weak VMO, excessive pronation of feet
42
What is the treatment for retropatella pain syndrome?
VMO/quads strength, quads flexibility, physio, patella taping, podiatry review
43
What is another name for patella tendinosis?
Jumper's knee
44
What are four types of traction apophysitis?
Osgood-Schlatter syndrome, Sinding-Larsen syndrome, bursitis, fat pad impingement
45
What is Osgood-Schlatter syndrome?
Inflammation of the patellar tendon at the tibial tuberosity
46
What is Sinding-Larsen syndrome?
Osteochondrosis of the patellar tendon
47
What are two types of thigh injuries and what are they caused by?
Cork thighs (charleyhorse) and intra/extramuscular haematoma; caused by direct trauma
48
What is the treatment for thigh injuries?
RICER
49
What is a complication of thigh injuries?
Myositis ossificans - calcification in muscle tissue, develops weeks after injury, may last for months
50
What is the treatment for myositis ossificans?
Rest, avoid aggravation, indomethacin (NSAID), surgery (rare)
51
What are three types of leg pain?
Compartment syndrome, tibial stress fractures, periostitis (shin splints)
52
What is compartment syndrome?
Increased pressure in muscle compartments of the leg, may be anterior, lateral, deep posterior or superficial posterior
53
What is the history of compartment syndrome?
Pain with activity
54
What is considered in the examination of compartment syndrome?
Tender, tight muscle compartments
55
What investigation is used for compartment syndrome?
Compartment pressure test
56
What is the treatment for compartment syndrome?
Conservative: Rest, ice, anti-inflammatories, massage, stretching Surgery: Fasciotomy vs. fasciectomy
57
What is the history of leg stress fractures?
Pain with activity, bony tenderness
58
What is considered in the examination of leg stress fractures?
Tenderness over bone
59
What investigations are used for leg stress fractures?
Bone scan, CT, MRI
60
What is the treatment for leg stress fractures?
Conservative: Relative rest, ice, anti-inflammatories, massage
61
What is the history of leg periostitis?
Pain with activity
62
What is considered in the examination of leg periostitis?
Tender medial tibial border
63
What investigations are used for leg periostitis?
Bone scan, x-ray, MRI
64
What are the treatments for leg periostitis?
Conservative: Relative rest, ice, anti-inflammatories, massage, physio, podiatry review Surgery (rare)
65
True or false: an achilles tendon rupture is an acute event
True
66
What is considered in the examination of an achilles tendon rupture?
Defect in tendon, lack of movement with squeeze test
67
What investigations are used for an achilles tendon rupture?
Ultrasound, MRI
68
What are the treatments for an achilles tendon rupture?
Surgery, conservative (walking boot)
69
What is the history of achilles tendinopathy?
Pain over heel during activity
70
What is considered in the examination of achilles tendinopathy?
Tender, swollen crepitus
71
What investigations are used for achilles tendinopathy?
Ultrasound, MRI
72
What are the treatments for achilles tendinopathy?
Conservative: Relative rest, ice, physio, eccentric strengthening program Injection: sclerosants, collegenase inhibitor Surgery: Remove degenerative tissue, calcification
73
What is the history of lateral ligament foot injuries?
Inversion injury
74
What is considered in the examination of lateral ligament foot injuries?
Pain, swelling, pain to bear weight
75
What investigations are used for lateral ligament foot injuries?
X-ray, MRI
76
What is the treatment for lateral ligament foot injuries?
Relative rest, ice, anti-inflammatories, physio
77
What is emphasised during the rehabilitation of lateral ligament foot injuries?
ROM, strength and proprioception
78
What complication is associated with lateral ligament foot injuries?
Risk of intra-articular injury
79
What is the history of an ankle syndesmosis injury?
Eversion, radiation
80
What is considered in the examination of an ankle syndesmosis injury?
Pain, swelling especially above the ankle, tender distal leg
81
What investigations are used for an ankle syndesmosis injury?
X-ray including weight-bearing views, MRI
82
What is an ankle syndesmosis injury also known as?
A high ankle sprain
83
What is the treatment for an ankle syndesmosis injury?
Conservative: Air-cast brace/boot, non-weight bearing | Surgery
84
What is the history of foot stress fractures?
Pain with activity
85
What is considered in the examination of foot stress fractures?
Tender foot bones
86
What investigations are used for foot stress fractures?
Bone scan, x-ray, CT, MRI
87
What are the treatments for foot stress fractures?
Conservative: Relative rest, non-weight bearing, plaster cast, brace Surgery
88
What is the history of navicular stress fractures?
Pain with activity
89
What is considered in the examination of navicular stress fractures?
Tenderness over navicular
90
What investigations are used for navicular stress fractures?
Bone scan, CT, MRI
91
What are the treatments for navicular stress fractures?
Conservative: Non weight-bearing immobilisation, walking cast Surgery
92
What tests are used for ankle fractures?
Percussion and compression tests
93
What test is used for Achilles tendon integrity?
Thompson test
94
What are four ankle stability tests?
Anterior drawer, talar tilt, Kleiger's and Medial Subtalar Glide tests
95
What tests are used for ACL injuries?
Drawer test at 90 degrees flexion, Lachman drawer test
96
What test is used for PCL injuries?
Posterior sag test (Godfrey's test)
97
What tests are used for meniscal injuries?
McMurray's, Apley's compression and Apley's distraction tests
98
What tests are used for patella examination?
Patella grinding, compression and apprehension tests

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