Knee Pathologies

A player hears a pop in her knee. She claims it can't be an ACL tear because nobody hit her. Why is she wrong?

70% of ACL injuries are non-contact (also females are 2-10x more likely to sustain an ACL injury than males playing the same sport)

A player plants his foot to cut and change direction and feels a pop in his knee with excruciating pain. This is a common MOI for what?

ACL Tear

Your player is testing positive for an MCL tear. Why should you also test for a meniscus tear as well?

Because the MCL ligament has two bands, and one of the bands inserts into the meniscus. It commonly tears the meniscus when torn.

A patient is TTP on the attachment sites of the LCL and not the MCL after receiving a hit to the lateral side of the knee. What injury do you suspect?

Bone Bruise to the attachment sites (hit to the lateral side usually is the MOI for an MCL tear, but there is only pain on the lateral side. This would indicate just bone bruising and no tear)

What is patellar tendonitis?

First initial S/S of pain in the patellar tendon resulting from an insidious onset.

What is an Osteochondral Defect (OCD)?

Fractures of the articular cartilage and underlying bone

Runners, cyclists, or other endurance athletes are most likely to get _________ if they have weak hip abductors, tensor fasciae latae, and gluteals

Ilitoibial Band Syndrome (IT Band Syndrome)

A patient is TTP on the attachment sites of the LCL after receiving a hit to the medial side of the knee. What injury do you suspect?

LCL Sprain/Tear

A player receives a hit to the medial side of the knee. What injury is this an MOI for?

LCL Sprain/Tear

What special tests help to diagnose an ACL tear?

Lellie's, Anterior Drawer, Pivot Shift, Lachman's

Patient hears a "pop". What does this S/S usually indicate?

Ligament Tear

A patient is tackled/hit from the lateral side of the knee. What injury is this the MOI for?

MCL Tear/Sprain

What is an "unhappy triad"?

MCL tear, ACL tear, and Meniscus Tear

What special tests help to diagnose a meniscus tear?

McMurray's, Apley's, Duck Walk, Thessaly's

Popping, clicking, grinding and a sensation of "giving out" are S/S of what injury?

Meniscus Tear

A patient presents with Grade 3 edema in the knee joint. What is this usually a key indicator of?

Meniscus tear and/or ligament sprain/tear

What special tests help to diagnose OCD?

Meniscus tests (but only WB ones, NWB tests will be negative)

What special tests help to diagnose Osgood Schlatters?

None - you should be able to tell from patient history

Younger boys going through growth spurts and that are involved in jumping sports are more likely to get what injury?

Osgood Schlatter's Disease

A patient has pain with WB, and complains of his knee "locking, giving out, and clunking" but it isn't as bad when he is NWB. What injury does this indicate?

Osteochondral Defect (OCD)

A player receives blunt force trauma to his anterior tibia while his knee is flexed. This is the MOI for what injury?

PCL Sprain/Tear

What is IT Band Syndrome?

Pain in the region of the lateral femoral condyle or slightly inferior to it, that occurs after repetitive motion of the knee

What special tests help to diagnose IT Band Syndrome?

Rene's and Obers

What special tests help to diagnose an MCL tear?

Valgus Stress Test

What special tests help to diagnose an LCL tear?

Varus Stress Test

What meniscus special tests will be positive for Osteochondral Defects (OCD) and which ones will be negative?

WB Meniscus Tests will be positive (Duck Walk, Thessaly's etc. ) NWB Meniscus Tests will more likely be negative (McMurray's, Apley's, etc.)

What is a meniscus tear?

a tear of the cartilage that provides a cushion between your femur and tibia.

What is patellar tendinosis?

progressive degeneration of the tendon. Pain continues and worsens affecting ADL's