Knee Flashcards
(37 cards)
If the mechanism of injury to the knee is twisting or rotational, what structure was likely injured, especially with the foot planted?
Meniscus
If the mechanism of injury to the knee is a valgus load such as impact to the lateral knee, what structures are likely to be injured, especially with the foot planted?
- medial meniscus
- MCL
- ACL
- injury to all 3 = terrible/unhappy triad
- LCL
If the mechanism of injury to the knee is a varus load such as impact to the medial knee, what structures are likely to be injured, especially with the foot planted?
- lateral meniscus
- LCL
If the mechanism of injury to the knee is an A to P impact to the anterior proximal tibia or patella, what structures are likely to be injured, especially with knee flexed?
- PCL
- patellar fracture
- bone bruise (patella or tibia)
If the mechanism of injury to the knee is a P to A impact to the posterior tibia, what structure is likely to be injured?
- ACL
What are the signs of a grade 1 knee sprain?
- localized pain and swelling
- no laxity on stress test
- no hemarthrosis
What are the signs of a grade 2 knee sprain?
- marked and more diffuse pain and swelling
- minimal laxity on stress test
- firm ligamentous end range
- hemarthrosis rarely present
What are the signs of a grade 3 knee sprain?
- significant laxity on stress test
- soft or empty end feel
- end range pain may be absent
- hemarthrosis is common
Anterolateral rotary instability is damage to ACL & Lateral complex -resulting in instability in the _____ and _____ direction
Anterior, medial
The damaged tissues are located anterolateral allowing excess anterior medial rotation
Anteromedial rotary instability is damage to ACL & medial complex -resulting in instability in the _____ and _____ direction
Anterior, lateral
The damaged tissues are located anteromedial allowing excess anterior lateral rotation
Posterolateral rotary instability is damage to PCL and lateral complex -resulting in instability in the _____ and _____ direction
Posterior and lateral
Posteromedial rotary instability is damage to PCL and medial complex -resulting in instability in the _____ and _____ direction
Posterior and medial
With generalized knee pain, what red flags do you need to rule out?
- radiculopathy
- referral from other area (hip OA, slipped femoral capital epiphysis, neoplasm, fracture, etc.)
- arthritides/inflammatory joint disease (RA, psoriatic, MS, ALS)
- fibromyalgia
- infection (Lyme disease)
When a patient presents with significant knee pain at rest that increases with movement, what red flags need to be ruled out?
- infection
- RA
- Gout
- cellulitis
- malignancy
What are the likely pain generators for a traumatic knee injury?
- menisci
- cruciate ligaments
- capsule
- bone (fracture)
What are the likely pain generators for a non-traumatic/ repetitive knee injury?
- menisci
- bone (OA)
- joint mice
- plica (embryologic remnant of synovial tissue)
- cruciate
If patient has painful muscle weakness around the knee, what are the possible causes?
- degenerative tendinopathy
- myofibrosis
- myofascitis
If patient has painless muscle weakness around the knee, what are the possible causes?
- complete muscle or tendon tear
- peripheral neuropathy
- nerve root damage
- reflex inhibition
- disuse atrophy
What are the 5 most common bursitis of the knee?
- prepatellar
- pes anserine
- semimembranous
- suprapatellar
- infrapatellar
What type of treatment is contraindicated for bursitis?
Cross friction massage
Knee pain, stiffness and swelling at the insertion of sartorius, gracilis and semi tendinosus is indicative of what kind of bursitis, usually due to lesions in kinetic chain, joint OA, infection or medial hamstring tendinopathy?
Pes anserine bursitis AKA subsartorial
Knee pain, stiffness and swelling at the posterior knee is indicative of what kind of bursitis?
Semimembranosus
What is the major DDX for semimembranosus bursitis that needs to be ruled out?
Baker’s/popliteal cyst
Knee pain, stiffness and swelling superficial to the patella, usually due to trauma, rocking forward on patella while kneeling, infection or inflammatory arthritis would be indicative of what kind of bursitis?
Prepatellar bursitis AKA housemaid’s knee
