MRAT - knee

Patellofemoral pain syndrome

-anterior knee pain with crepitus -positive *Clarke's sign* -abnormal bony contact between the laterally tracking patella and the femoral groove -*can be caused by weak VMO/tightness in ITB* -joint stiffness after sitting with the knee in a flexed position -postural alignment test : *static*-> Q-angle: ASIS-midpoint of patella, tibial tubercle *dynamic*-> Step-down test

ACL Hx

A sudden pop & anterior knee pain with posterior lateral joint line pain Instability of the knee is common

Sindig Larsen Johansson Disease

Apophysitis of the distal pole of the patella

Jumper's Knee

Associated with high quadriceps loading: jumping, squatting, and kneeling Overuse syndrome

Popliteal Bursae

Baker's Cyst

LACHMAN TEST

Best indicator of injury to ACL

Prepatellar Bursae

Between the skin & the anterior patella Housemaid's Knee

Superficial or Subcutaneous Infrapatellar Bursae

Between the skin & the tibial tuberosity Vicar's / Parson's Knee

Recurrent Patellar Sublaxation

Congenital (lateral lip is more prominent than medial) Weak VMO -->lateral displacement Inc. Genu Valgum/Varum/Recarvatum Ext. Tibial Torsion

Medial meniscus Tear MOI

Cutting injuries Tibial rotation while the knee is partially flexed during weight bearing (football, soccer)

Patellofemoral Pain Syndrome Sx

Diffuse aching anterior knee pain Worse after prolonged sitting, climbing stairs, jumping or squatting Catching sensation

assess the knock knee through? (genu valgum)

Distance between medial malleoli < 8cm

Plica

Embryological remnants that have remained in some people after birth Normally, they are reabsorbed by the time of birth Abnormal plica can mimic meniscus pathology

Bone-Patella-Bone (BTB) Graft

Gold standard tx for ACL injury Patellar tendon graft is harvested through a 3-4" long vertical incision based just along the medial (inside) border of the tendon

Chondromalacia patellae (runner's knee)

Involves a softening of the cartilage under the patella, which results in wearing away of this cartilage. MC site: ODD facet

Osteochondritis Dissecans

Localized segmental area of AVN of the end of a long bone Formation of dead subchondral bone covered with articular hyaline cartilage — subchondral separation MC in adolescents

assess the bow leg through? (genu varus)

Measured by both heel together Distance between knees < 6cm

A patient's severe knee sprain resulted from medial rotation of the femur on the tibia with simultaneous application of a valgus force while the foot was placed on the ground. Which structures are MOST likely to be involved?

Medial collateral ligament, medial meniscus and anterior cruciate ligament

Pellegrini Steida Disease

Myositis Ossificans of Medial Collateral Ligament of Knee

Theatre or cinema sign indicates

PFPS

Patellofemoral Arthralgia

Pain in the joint between the patella and the femur Anterior knee pain "pain under the knee cap"

lliotibial band friction syndrome

Pain over the lateral femoral condyle as the ITB crosses the bony prominence at 30° flexion Inflexibility of the ITB & adductor/abductor muscle imbalances lead to the dysfunction

Osgood Schlatter Disease

Partial/ separation or apophysitis of the tibial tubercle M>F; 10-14 y/o

Blount's disease

Progressive bow-leg deformity associated with abnormal growth of the posteromedial part of the tibia Common among overweight children

Lateral meniscus Tear MOI

Squatting Full flexion with rotation is the usual mechanism (wrestling)

True

T or F: PCL injuries are much less common than ACL injuries

Chondromalacia patellae causes

Tight iliotibial band Neuromas Bursitis Overuse Malalignment Core instability Patellar maltracking

ACL tear MOI

Usually cutting, deceleration, & hyperextension of the knee Low-velocity, noncontact, deceleration injuries and contact injuries with a rotational component

MCL tear MOI

Valgus stress (lateral blow) Impact force to the lateral knee | is often the mechanism of injury

PCL tear MOI

dashboard inury direct trauma to tibia with knee flexed In athletics, hyperflexion is a common means of PCL injury

Sindig Larsen Johansson Disease cause

excessive force exerted by the patellar tendon on the lower pole of the patella pain, which increases when the patellar is loaded during flexion, subpatellar swelling & functional limitation

Patella alta

high patella

Jumper's Knee site of tenderness

insertion of patellar tendon and tibial tubercle MC site of involvement is the inferior pole of the patella

LCL tear leads to?

knee dislocations

Patella baja

low patella

Osteochondritis Dissecans MC inv in knee joint

medial femoral condyle

ACL

most commonly injured knee ligament in athletics (football, soccer, downhill skiing)

Meniscal Tears is associated with?

pop after a specific inciting incident May cause true locking Frequently complain of knee stiffness