Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

P-2 Ortho 3 > Lecture 6 > Flashcards

Lecture 6 Flashcards

(69 cards)

Start Studying
1
Q

What is knee tendonitis?

A 
Extensor mechanism tendinitis is an overuse injury involving either 
the:
quadriceps tendon 
or 
patella tendon

(Above or below)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Who is prone to knee tendonitis?

A

Adults < 40 yrs who do jumping or kicking sports

“jumpers knee”

Adults >40 yrs after change in exercise level or substantial weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hallmark of knee tendonitis?

A

Anterior knee pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the pain for knee tendonitis

A 
Anterior knee pain
Immediately after exercise
Pain with: 
- Prolonged sitting
- squatting
- kneeling

Climbing stairs, running, squatting or jumping makes it worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PE for knee tendonitis will show?

A

TTP at quad or patellar tendon

Mild infrapatella bursa swelling

Loss of ROM secondary to pain (can be forced)

Quadriceps atrophy (chronic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diagnostic tests for knee tendonitis?

A

Radiograph: normal except:

  • some chronic findings
  • or w Osgood-schlatter disease

MRI reserved for recalcitrant cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What will radiographs show with chronic tendonitis?

A

Small osteophytes

Heterotropic ossification at the upper or lower pole of patella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What will show on x ray with a PMH of Osgood-Schlatter disease for tendonitis pts?

A

Large ossicle from an unhealed tibial tuberosity apophysis

Maybe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for knee tendonitis?

A

Phased approach

  1. Control inflammation
  2. Achieve full ROM
  3. strength conditioning back to 90%
  4. Agility drills/RTD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

He really liked PRICES, what does it mean?

A

Some guy wanted to get known for something but didnt have anything good so he added protection/pain meds and support,strength/stretching to bookend RICE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some treatment adjuncts for knee tendonitis?

A 
Braces
PRP
Surgical debridement
Excision of nonunited tibial tuberosity ossicle 
Unicorn tears
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What tendonitis pts get referred?

A

Possible rupture of extensor mechanism (refer ASAP)

Cases recalcitrant to non-operative management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is patellofemoral pain?

A

Constellation of problems characterized by a diffuse aching anterior knee pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What makes patellofemoral pain better and worse?

A

Worse:
Increase in activity that places additional loads across patellofemoral joint

Running
Stairs
Kneeling
Squatting

better:
Not doing those things

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Patellofemoral pain is secondary to?

A

Overuse syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Though it causes anterior knee pain ____ is not considered patellofemoral pain.

A

Misalignment (bad Q angle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Chondromalacia patella is not the same as patellofemoral pain. Why?

A

Chondromalacia indicats that pathologic changes are present in the articular surface of patella
Not always the case here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chondromalacia patella is aka?

A

Runners knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical symptoms of patellofemoral pain?

A

Diffuse aching anterior knee pain

Worse after:

  • prolonged sitting (theater sign)
  • stairs
  • jumping
  • squatting

Maybe instability of retropatellar catching sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Does patellofemoral pain knee swell?

A

Nope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How should i examine my patellofemoral pain pts?

A

Weight-bearing stance

Watch them walk

Look at Alignment (genu valgum foot pronation (flat foot))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What if the patient’s patella point toward eachother while walking?

A

Increased femoral anterversion

May increase patellofemoral pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is patellar apprehension sign?

A

Indicates patellar instability

With the knee extended translate the patella laterally and then flex the knee 30%

Discomfort or “apprehension” is instability

Palpate patella for crepitus in ROM

Slide 22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

X rays of the sunrise view of patella is diagnostic for patellofemoral pain if?

A

The patella is not in the femoral grove

Fancy words are:
Patellar subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Treatment for patellofemoral pain
Activity mod Strengthening and flexibility Modified quadricep exercises to avoid causing knee pain NSAIDS Patellar pad or knee sleeve to isolate patella Steroids (maybe) Surgery (maybe)
26
Which way does the patella typically dislocate?
Commonly lateral dislocation
27
Predisposing factors for patellar instability
Patella alta Shallow trochlear groove Ligamentous laxity Muscular imbalance (VMO)
28
Patellar instability can cause dislocations What 2 ways do patellar dislocations present?
Obvious dislocation Transient dislocation (w spontaneous reduction)
29
How does patellar instability present?
``` Patellar dislocation Sever pain Audible pop Acute hemarthrosis Loss of motion (Mimics ACL injuries) ```
30
Primary symptoms of patellar instability?
``` Malalignment Retropatellar pain Exacerbated w - stairs (descending) - Movie theater sign - Squatting ```
31
What will long-standing maltracking of the knee cause?
Excessive pressure on the lateral facet of the patella and lateral trochlea can result in progressive degenerative changes involving the lateral patellofemoral joint
32
PE for patellar instability?
``` + apprehension sign Limited ROM (pain) + TTP over MFPL (acute) Femoral anteversion/genu valgum Patella alta Increased patella mobility Tight lateral retinaculum ``` Chronic: + apprehension but no TTP Acute: + apprehension and TTP
33
Diagnostic tests for patella instability?
Sunrise x ray: dislocated patella CT: exact nature of patellar and trochlear articulations MRI: good view of articular surfaces and medial patellofemoral ligament
34
What will patellar instability or multitracking result in over time?
Secondary quadricep weakness (leading to more instability) Patellofemoral chondrosis (from abnormal stresses on cartilage) Continued dislocations can shear off a fragment of articular cartilage (leading to locking)
35
Treatment for patella instability?
Acute - Brace - RICE - Isometric exercises for quads Once tenderness goes down - ROM and strengthening exercises
36
How long should immobilization be done for patellar instability injury?
Varies but not to exceed 4 weeks They should still do quadricep exercises during this phase
37
If i have a first time patellar dislocation or high energy dislocation what needs to be considered?
More imaging to r/o pathology: - bony avulsion - medial patellofemoral ligament - Osteochondra fx They may need surgery
38
What is the focus of PT for patellar instability?
Exercise emphasizing quadriceps strengthening and flexibility
39
Surgery for patellar instability?
If non surgical measures fail: Fulkerson’s procedure (patellar realignment)
40
What is the MC synovial cyst in the knee?
Popliteal cyst
41
What is the synovial cyst of the knee?
Bakers cyst Develops in the popliteal bursa in the posteromedial aspect of the knee
42
Popliteal cysts are associated with ___?
Degenerative meniscal tears and systemic inflammatory conditions such as RA
43
What can a ruptured cyst be mistaken for?
DVT Can cause swelling and pain in calf so is mistaken for deep vein thrombosis
44
What is mass effect?
Large cysts can cause numbness of the plantar surface of the foot Tibial nerve neuropathy
45
When do you commonly see ruptures of popliteal cysts?
Usually in pts >40 with RA or degenerative arthritis
46
Where are popliteal cysts usually found?
Between the semimenbranous muscle And medial head of of the gastrocnemius muscle Slide 50 for pic
47
Diagnostic tests for popliteal cyst?
Radiographs: negative MRI: intraarticular pathology US: characterize the cyst and guide procedure
48
Best thing to do for treatment of popliteal cyst?
Nothing - its benign Aspiration is discouraged
49
Signs that a popliteal cyst is not actually a popliteal cyst?
Cancer: night pain, wt loss, fever/chills, constitutional symptoms Aneurysm: pulsatile mass w/in the popliteal cyst
50
Definition of chronic leg pain?
Pain for more than 2-3 weeks
51
Examples of chronic leg pain?
Tibial stress syndrome (shin splints) Chronic exertion compartment syndrome Popliteal artery entrapment syndrome Stress fractures
52
MC exercise induced leg syndrome?
Tibial stress syndrome (shin splints) an overuse injury
53
Common locations of tibial stress syndrome?
Posteriomedal (MC) Anterolateral
54
Second MC exercise induced leg syndrome?
Chronic exertional compartment syndrome
55
Who gets chronic exertional compartment syndrome?
Males>females Usually in 30’s
56
What compartment is the MC for chronic exertional compartment syndrome?
Anterior leg compartment
57
Symptoms of chronic exertional compartment syndrome?
Aching and burning in leg Paresthesias over dorsum Exercise aggravates Rest relieves Exam is normal
58
How is chronic exertional comparment syndrome diagnosed?
Radiographs are normal so we do Compartmental pressure measurement
59
Best treatment for chronic exertional compartment syndrome
Activity mod Dont cut these people fasciotomy is not the answer
60
What is popliteal artery entrapment?
Popliteal artery gets compressed in the calf causing symptoms similar to chronic exertional compartment syndrome
61
Symptoms of popliteal artery entrapment?
``` Extremity edema Foot paresthesias Calf cramping Diminished pulses with: - active plantar flexion - passive dorsiflexion ```
62
Diagnostic test for popliteal artery entrapment?
X-ray pretty normal MRI Doppler US Arteogram may help
63
Treatment for popliteal artery entrapment?
Conservative: activity mod Surgery: - vascular bypass with saphenous vein - endarterectomy
64
What is a stress fracture?
A microscopic break in a bone caused by microtrauma and cumulative overload to bone ``` Overtraining Incrorrect biomechanics Fatigue Hormonal imbalance Poor nutrition Vitamin D Osteoporosis ```
65
What stress fractures have poor prognosis?
Anterior tibial stress fractures They may require surgery
66
Exam for stress fracture?
Basically the same as every other thing
67
X rays for stress fx?
Get them (they will show nothing) Wait 3-4 weeks and do them again. They may show up
68
What diagnostic tests are good for stress fractures?
Bone scans | MRI
69
What is different about the tx for stress fx?
Avoid NSAIDS And If you get the black line x ray you’re getting the tibial nail

P-2 Ortho 3 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions