The Knee Flashcards

(31 cards)

1
Q

Pre-patellar bursitis clinical features

A
Housemaids knee 
Bursa above the patellar 
Excessive kneeling
Localised pain and tenderness
Swelling
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2
Q

Pre-patellar bursitis specific tests

A

Balloon sign
Fluctuant
Swelling

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3
Q

Pre-patellar bursitis investigations

A

Aspiration with gram stain and culture

USS

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4
Q

Pre-patellar bursitis management

A

Conservative

  • compression
  • NSAIDS
  • aspiration

Surgery
-bursectomy

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5
Q

Intra patellar bursitis clinical features

A
Clergymans knee
Above the patellar lig
Pain just bellow knee cap
Swelling
Kneeling
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6
Q

ACL rupture clinical features

A
LFC-> anterior tibia 
50% also have a meniscal tear 
Fixed foot with knee flexion and internal hip rotation 
Felt pop
Deep knee pain 
70% immediate swelling
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7
Q

ACL rupture specific tests

A

Anterior draw test-> no end point and pain

Lack mans -> hold leg with knee in 30 flexion and pull tibia anteriorly

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8
Q

ACL rupture investigations

A

X RAY -> segond # convulsion proximal tibia

MRI

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9
Q

ACL rupture management

A

Conservative

  • activity modification
  • physio
  • analgesia

Surgery
-ACL reconstruction

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10
Q

PCL rupture clinical features

A

Posterior tibial sulcus -> anteriomedial femoral condyle
Direct blow to proximal tibia
Non contact hyper flexion with plantar flexed foot
Posterior knee pain
Knee instability

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11
Q

PCL rupture specific tests

A

Posterior draw test

Posterior draw test

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12
Q

PCL rupture investigations

A

X Ray -> avulsion #
Lateral stress view
MRI

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13
Q

PCL rupture management

A

Conservative

  • protected wt bearing
  • physio
  • immobilisation in extension 4w

Surgery
- # / other ligs / unstable

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14
Q

Medical collateral ligament rupture clinical features

A

Most commonly injured ligament of the knee
Valgus and external rotation to the lateral knee
Felt pop
Medical joint line pain
Instability
Swelling

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15
Q

Medical collateral ligament rupture specific tests

A

Valgus stress test at 30 flexion -> no end point and pain

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16
Q

Medical collateral ligament rupture investigations

17
Q

Medical collateral ligament rupture management

A

Conservative -> incomplete

  • NSAIDS
  • rest
  • physio
  • bracing

Surgery

  • repair
  • reconstruction
18
Q

LCL rupture clinical features

A
Rarely an isolated injured 
Direct blow to wt bearing medial knee 
Excess virus and external rotation 
Instability in extension 
Difficulty with stairs 
Lateral joint line pain 
Swelling
19
Q

LCL rupture specific tests

A

Varus stress test at 30 flexion

Hyper extension when walking

20
Q

LCL rupture investigations

21
Q

LCL rupture management

A

Conservative -> intact/partial

  • limited immobilisation
  • progressive ROM
  • physio

Surgery
-repair

22
Q

Meniscal injury clinical features

A

Common with ACL rupture
Medical more common

Localised pain and tenderness
Mechanical locking
Delayed/intermittent swelling
-twisting/flexion injury

23
Q

Meniscal injury specific tests

A

Joint line tenderness

Mc Murrays-> flexion and external rotation, slowly extend-> pain and locking

24
Q

Meniscal injury investigations

A

X Ray normal

MRI

25
Meniscal injury management
Conservative - rest - NSAIDS - physio Surgery - repair - partial menisectomy
26
Patellar dislocation clinical features
Instability Anterior knee pain Swelling Non contact twisting injury with knee extended and feet externally rotated Often relocate by reflexive quads contraction
27
Patellar dislocation specific tests
Increased patellar translocation Patellar apprehension on lateral translation J sign -> lateral subluxation of the patellar on flexion
28
Patellar dislocation investigations
X Ray -> #, trochlear dysplasia -CT-> measure trochlear grove MRI -> soft tissue damage
29
Patellar dislocation management
Conservative - NSAIDS - short term immobilisation - activity modification - physio Surgery - arthroscopic debridement - MPFL repair
30
Pes Anserine Bursitis clinical features
Bursa under the pes anserine muscles -> sartorius, gracillis, semitendinosus ``` Tight hamstrings Direct blow to medial knee Localised pain and tenderness Worse on stairs Swelling Sport ```
31
Pes Anserine Bursitis management
Conservative - rest - NSAIDS - physio/stretching - steroid Surge -decompression