Knee

Question 1

• 15-30, F
• Overuse/overload of joint
• (-) loaded knee extension (stairs, squats, kneeling)
• PERIPATELLAR knee pain

Answer 1

Test:
Squatting
Patellar compression
Resisted knee extension
Clarkes (Grind test)

Management
Load management > strengthen (quads, gluts)

Question 2

• 15-30, M (uni or bi)
• Overuse
• Anterior knee pain below patella
• Warm up effect
• PROM end range knee flexion = pain
• (-) patellar grind
• Management?

Answer 2

Patellar Tendonitis “Jumpers Knee”

Tets:
Point tenderness below patella (best)
Single leg stance/squat

• Stretch > strengthen (closed chain eccentric)

Question 3

• 15 - 50 (any active athlete)
• Lateral knee pain (progressive, sharp, diffuse)
• Snapping/popping often associated
• +/- RADIATE INTO LATERAL THIGH (GREATER TROCH)
• (-) DOWNHILL running, DOWN stairs
• Management?

Answer 3

ITB tendinopathy “runners knee”

Tests:
Nobel Compression, Ober

Management:
Load management > decrease downhill run > strengthen (knee and hip)

Question 4

• 20-40, M (3:1)
• RF: obesity, overuse, athletes
• +/- clicking, swelling (delayed), bakers cyst (chronic)
• A/PROM +/- pain, clicking/locking
• Aggravation: deep knee flexion (squatting, kneeling)
• Management?

Answer 4

Meniscal Tear

Test:
JOINT LINE TENDERNESS
Apley compression
Mcmurray’s
Thessaly

Management
Progressive weight bearing > surgery

Question 5

• Any age
• MIO: excessive stress or physical damage
• RF: physical activity, obesity, chronic overuse
• pain is dull, achy, worse with movement
• LOCAL SWELLING

Answer 5

Bursitis

Test: aggravated w/ AROM of its “coordinating” mm

Management:

Answer 6

Popliteal bursitis

Question 7

• 15-30, rare occurence
  Lateral knee tenderness worse with full extension
• Feeling of instability
• A/PROM pain with full extension
• DDX: Common Peroneal Nerve pathology
• Management/Imaging?

Answer 7

LCL

Test: Varus stress Test (strain vs rupture?)

Management: Ottawa rules > PRICE > PFROM > Closed Chain > Open chain > Wobble board

Question 8

• 15-35, swimmers
• MOI: Valgus force
• Associated with medial meniscal tears
• +/- swelling
• Management/Imaging?

Answer 8

MCL

Test:
- Valgus Stress Test (0 and 30)
- Direct palpation

Xray if suspect fracture (Ottawa rules)
PRICE > PFROM > closed chain > open chain > wobble board
Mild-mod - 3 months, severe - 6-9 months

Question 9

• Mc young, M (3:1)
• Cycle of worse, better, worse
• MOI: knee flexion + rotation
• Locking, swelling
• A+PROM - end range with mechanical blocking
• Management/imaging?

Answer 9

Test: Apley, Thessaly (disco), McMurray

MRI (GS) > PRICE > PFROM (prevent atrophy) > Strengthen (low impact - bike, swim)

Question 10

• FEMALE (6:1), 15-30
• MOI: rapid deceleration + sharp change in direction,
  SINGLE LEG
• Deep pain, Pop, IMMEDIATE EFFUSION
• Associated with other knee injuries
• A/PROM - limited in extension
• Management/imaging?

Answer 10

Test: Anterior Drawer, Lachmans

• Ottawa rules > MRI (GS) > PRICE > Core + PFROM >
  Closed chain > Open chain > low impact exercise > WB

Question 11

• 15-35, M, RARE
• Deep pain, HEMARTHROSIS
• MOI: Flexed knee (fall, dashboard) or hyperextension
• INSTABILITY
• Associated with other injuries
• Management/Imaging?

Answer 11

PCL

Test: Posterior Sag Sign, Posterior Drawer

• MRI (GS) > PRICE > PFROM > Close chain > Open chain > low impact strengthening + core > WB

Question 12

• 10-15 (active pre-teens), Boys (5:1)
• Insidious onset after intense activity
• Focal tenderness, pain, swelling,
• (-) RROM - Extension
• Management/imaging

Answer 12

Osgood Schlatter’s
aka “avulsion of TT”

Test: Ant test challenging the quadriceps tendon

Management:
Xray > stop athletics for 2 weeks > stretch quad + hams > PFROM > increase activity accordingly

Question 13

• Rare injury, Professional runner/athlete
• MOI: direct varus force or while knee is ER or
  HYPEREXTENSION
• Acute pain in posterior/lateral knee joint
• Crepitus,
• PAINFUL RROM 15-30 degrees

Answer 13

Popliteal tendonitis

Tests:
Tenderness at LE, swelling, redness