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knee conditions Flashcards

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1
Q

what are s&s of pre-patellar bursitis?

A

swelling and bruising over the anterior knee
pain over the anterior patella

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2
Q

what are s&s of infrapatellar bursitis?

A

swelling and bruising just below the patella
pain over the anteroinferior patella

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3
Q

which muscles attach to the pes anserine?

A

sartorius
gracilis
semintendinosus

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4
Q

what are risk factors for developing pes anserine bursitis?

A

overweight
women
ankle hyperpronation
cyclist

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5
Q

what are s&s for pes anserine bursitis?

A

localised pain over the pes anserine
painful knee flexion

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6
Q

what is the management for pes anserine bursitis?

A

rest, avoid aggravating activities
trp of affected muscles
orthotics

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7
Q

what are s&s for semimebranous bursitis?

A

pain at tendon insertion or in bursa between the tendon & medial head of gastroc on the posterior knee

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8
Q

what are the s&s of biceps femoris bursitis?

A

pain and swelling at biceps femoris tenson at the head of the fibula (posterior)
(common in sprinters due to overuse)

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9
Q

what are the s&s for popliteus bursitis?

A

localised pain in the posterolateral knee
tendon can be palpated with knee at 90° under resisted medial rotation of tibia

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10
Q

what is a baker’s cyst?

A

fluid-filled sac in the medial popliteal fossa
most commonly originates from the medial hamstring tendon

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11
Q

what are s&s of a baker’s cyst?

A

pain, fullness, stiffness in the posterior knee
fluctuant swelling and tenderness of the posterior knee
decreased ROM if its a large cyst
aching in the popliteal fossa

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12
Q

when is the foucher’s sign positive?

A

if the baker’s cyst disappears when the knee is flexed

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13
Q

what is chondrocalcinosus?

A

calcification of the cartilage/meniscus

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14
Q

what are the risk factors for developing chondrocalcinosus?

A

dehydration
diuretics

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15
Q

what is gout?

A

build up of uric acid crystals (occurs from breakdown of purine: alcohol, game meats and fish)

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16
Q

what is the most common site for gout to occur?

A

1st metatarsal joint

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17
Q

what are s&s for gout?

A

red, hot and swollen joints (need to rule out septic arthritis)

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18
Q

what is the pharmaceutical treatment for gout?

A

allopurinol

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19
Q

what is the most common site for CPPD or pseudogout to occur?

A

knee
triangular fibrocartilage

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20
Q

what are risk factors for developing CPPD?

A

> 50-60 years
diabetes
hyperparathyroidism
gout

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21
Q

which meniscus is most commonly affected?

A

medial meniscus

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22
Q

what are s&s for a meniscal tear?

A

pain within the joint line
painful clicking, popping and locking
swelling
+ve McMurray’s test
reduced ROM

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23
Q

what is the imaging of choice for a meniscal tear?

A

MRI

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24
Q

what is a parrot break in the knee?

A

a visible lump with leg at 45° when lateral meniscus is torn

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25
what is a cleavage tear in the knee?
posterior horn of the medial meniscus is torn
26
what is the Osgood-Schlatter disorder?
traction apophysitis (growth plate inflammation) of the tibial tuberosity due to repetitive stress by the patella tendon
27
who is most at risk for developping Osgood Schlatter disorder?
sporty boys (up to 16 yrs)
28
what are s&s for osgood Schlatter disorder?
prominent bulge over tibial tuberosity (anterior knee) pain on kneeling down pain on going up and down stairs pain, swelling and tenderness over the tibial tuberosity RROM extension
29
what is the imaging of choice for osgood schlatter disorder?
x-ray
30
what is the management for osgood schlatter syndrome?
self limiting 12-24 months anti-inflammatory analgesic stretching quads and hamstrings graded return to sport
31
what is osteochondritis dissecans?
necrosis of segments of the femoral condyle which may form intra-articular loose bodies
32
what is the most common site for osteochondritis dissecans?
lateral aspect of the medial femoral condyle
33
who is most likely to develop osteochondritis dissecans?
boys between 5-15 years
34
what are s&s of osteochondritis dissecans?
poorly localised aching knee pain swelling worse with strenuous activity and twisting motions of knee (particularly internal rotation patient may walk with externally rotated leg knee locking (knee gives away when walking)
35
what are the s&s of osteonecrosis?
persistent pain, swelling and stiffness pain often worse at night
36
what is the imaging of choice for osteonecrosis?
MRI (x-ray may only show after 3 months)
37
what is the management for osteonecrosis?
avoid sport or precipitating activities for 6-8 weeks gentle physical therapy analgesics grade III and IV need surgery
38
which type of athletes are most at risk for developing patella tendinitis?
sports including repetitive jumping (basketball, volleyball, football, high jumps)
39
what are s&s of patella tendinitis?
gradual onset anterior knee pain (below the patella) pain worse with activity and better with rest localised swelling over patella tendon
40
what is the management for patella tendinitis?
avoid sport and precipitating activities stretching of calves, hamstrings and quads
41
what is patellofemoral pain syndrome?
pain over the anterior knee due to overuse of the knee (most common in young females 13-15 yrs due to greater hip adduction)
42
what are s&s of patellofemoral pain syndrome?
pain behind the patella and deep knee crepitus within the patella pain on compression and side-to-side movement of the patella 'movie sign': has to straighten out leg after prolonged sitting pain is worse with loaded knee flexion activities (climbing stairs, walking down slopes, squatting and prolonged sitting)
43
what is the management for patellofemoral pain syndrome?
VMO and quad strengthening (eccentric > concentric) hip abductor strengthening foot orthotics for hyperpronation patella taping acupuncture
44
what is the most common cause of a quadriceps strain?
forceful contraction during forced muscle lengthening
45
what are s&s of quadriceps rupture?
sudden pain over quadriceps pop or sensation like an elastic band snapping palpable defect in quadriceps or infrapatellar tendon
46
what is the most common mechanism of injury for an anterior cruciate ligament (ACL) sprain?
twisting of knee sudden change in direction blow through foot with a flexed knee
47
what are the s&s for ACL sprain?
onset of severe pain after sports injury swelling (within 30 min) feeling as if knee gives away or is loose inability to weight bear painful ROM
48
which special tests would be positive in ACL sprain?
lachman's test anterior draw test pivot shift test
49
which ligaments/structures are associated with the unhappy triad of the knee?
ACL medial meniscus MCL
50
what is the imaging of choice for an ACL sprain?
MRI
51
what is the mechanism of injury in a posterior cruciate ligament (PCL) sprain?
A-P blow to tibia in a flexed knee (with foot plantar flexed creating reduced tibial stabilisation)
52
what are the s&s for PCL sprain?
pain in posterior knee pain radiating into calf limited running/jumping no moderate swelling genu rectuvatum
53
which tests are positive in PCL strain?
posterior sag sign +ve posterior draw
54
what is the management for grade 1-2 PCL sprain?
graded rehabilitation program 0-4 weeks: brace in slight flexion + RICE 2-6 weeks: dynamic ROM exercises, static cycling and quad strengthening 4-12 weeks: closed chain: half squats, leg presses, resistance cycling, light jogging > 12 weeks: return to activity return to sport if quad and hamstring strength are 90% of non-involved side (4-6 weeks)
55
what is the management for a grade 3 PCL sprain?
surgical referral
56
what is the synovial plica syndrome?
fold of synovium which gets caught between the patella and femur during walking
57
what are s&s of plica syndrome?
acute aching in the medial patellofemoral joint mild effusion
58
what is the management for synovial plica syndrome?
generally resolves without treatment US cross-friction electrical stimulation
59
what are s&s of popliteus tendonitis?
localised tenderness in posterior/posteriolateral knee pain provoked by running and prolonged standing TTP popliteus tendon (with knee at 90°) pain in resisted tibial rotation
60
what are s&s of pes anserine tendonitis?
localised tenderness over pes anserine tubercle
61
what are s&s for semimembranosus tendonitis?
tenderness over insertion into the posteromedial tibia
62
what are s&s of biceps femoris tendonitis?
tenderness over the insertion into the posterolateral tibia

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