Knee Pain Evaluation and Diagnosis Quiz

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What percentage of adults does knee pain affect?

10%

25% (correct)

60%

40%

How much has the prevalence of knee pain increased over the past 20 years?

20%

50%

35%

65% (correct)

How many primary care visits does knee pain account for annually?

2 million

4 million (correct)

3 million

1 million

What does musculoskeletal ultrasonography allow for detailed evaluation of?

Effusions and cysts Signup and view all the answers

When is magnetic resonance imaging rarely used for patients?

For urgent referral cases Signup and view all the answers

What are key aspects of the patient history in evaluating knee pain?

Location, onset, duration, and quality of pain Signup and view all the answers

What is a common cause of chronic lateral knee pain in runners or cyclists?

Iliotibial band syndrome Signup and view all the answers

Which condition may present with anterior knee pain?

Patellofemoral pain syndrome Signup and view all the answers

What may be the cause of posterior knee pain?

Symptomatic popliteal (Baker) cyst Signup and view all the answers

What is a common cause of chronic, diffuse knee pain in adults over 50?

Degenerative knee osteoarthritis Signup and view all the answers

Which symptom suggests internal derangement or medial plica syndrome?

Locking Signup and view all the answers

What does swelling that occurs immediately after injury suggest?

Ligament rupture Signup and view all the answers

What should be considered when patients are unable to walk or limp immediately after injury and at first presentation?

Fracture Signup and view all the answers

What could be included in the workup for knee pain?

Serology for suspected inflammatory conditions Signup and view all the answers

What type of examination was completed using Clinical Queries for knee pain evaluation?

PubMed search Signup and view all the answers

What was validated for early detection of meniscal tears?

The Thessaly test Signup and view all the answers

What did EULAR provide evidence-based recommendations for?

Diagnosis of knee osteoarthritis Signup and view all the answers

What was systematically reviewed for ruling out knee fractures?

The accuracy of the Ottawa knee rule Signup and view all the answers

What did the American Medical Society for Sports Medicine recommend for sports medicine fellowships?

Sports ultrasound curriculum Signup and view all the answers

What was conducted for the use of radiography in acute, high-risk knee injuries?

Multicenter comparison of two clinical decision rules Signup and view all the answers

What has been reported in survey and cohort data?

Increasing prevalence of knee pain and symptomatic knee osteoarthritis Signup and view all the answers

Which of the following is NOT a risk factor for knee osteoarthritis?

Regular participation in high-impact sports Signup and view all the answers

What is a validated tool that decreases unnecessary radiography by 28% to 35% in patients with an acutely injured knee?

The Ottawa Knee Rule Signup and view all the answers

What type of radiographic views are recommended for knee evaluation?

Anteroposterior, lateral, and Merchant's views Signup and view all the answers

When should radiography be reserved for knee pain?

For chronic knee pain of more than six weeks duration Signup and view all the answers

What does musculoskeletal ultrasonography allow for limited evaluation of?

Tendons, ligaments, and muscles Signup and view all the answers

What is included in a systematic approach to knee examination?

Inspection, palpation, range of motion evaluation, and neurovascular assessment Signup and view all the answers

What is a specific manifestation of knee conditions that should be noted during palpation?

Pes anserine bursitis Signup and view all the answers

Study Notes

Evaluation of Knee Pain and Diagnosis

Laboratory examination can play a confirmatory or diagnostic role when initial history and physical examination suggest but do not confirm a specific diagnosis.
Workup could include serology for suspected inflammatory conditions, autoimmune conditions, or microscopic examination of arthrocentesis fluid for gouty crystals or evidence of bacterial infection.
A PubMed search was completed using Clinical Queries and the search terms knee pain, evaluation, history, examination, radiographic imaging, laboratory, diagnosis, effusion, gout, and pseudogout.
The search included meta-analyses, randomized controlled trials, clinical trials, and reviews.
Increasing prevalence of knee pain and symptomatic knee osteoarthritis has been reported in survey and cohort data.
General practitioner diagnosis and management of acute knee injuries were summarized in an evidence-based guideline.
The Thessaly test and a new clinical test (the Thessaly test) were validated for early detection of meniscal tears.
EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis were provided.
Epidemiology of osteoarthritis and diagnosis and treatment of gout and pseudogout for everyday practice were discussed.
Multicenter comparison of two clinical decision rules for the use of radiography in acute, high-risk knee injuries was conducted.
American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships.
The accuracy of the Ottawa knee rule to rule out knee fractures was systematically reviewed.

Knee Examination and Diagnostic Imaging in Primary Care

Family physicians should inquire about previous knee or joint pain, injuries, surgeries, systemic medical conditions, and family history of autoimmune and degenerative conditions.
Established risk factors for knee osteoarthritis include personal history of knee injury or surgery, family history of knee osteoarthritis or joint replacement, age older than 50 years, female gender, and being overweight.
A systematic approach to knee examination involves inspection, palpation, range of motion and strength evaluation, neurovascular assessment, and special (provocative) tests.
Specific manifestations of knee conditions, such as pes anserine bursitis and plica, should be noted during palpation.
Neurovascular examination of the knee includes assessment of sensation, tendon reflexes, and palpation of pulses.
Special (provocative) tests are used to assess specific structures of the knee and may be limited by pain and effusion in the acute setting.
Radiography may be necessary for undifferentiated knee pain, but should be reserved for chronic knee pain of more than six weeks duration or acute traumatic pain in specific cases.
The Ottawa Knee Rule is a validated tool that decreases unnecessary radiography by 28% to 35% in patients with an acutely injured knee.
The Pittsburgh Knee Rule appears to be more sensitive than the Ottawa rule in reducing unnecessary radiography.
Recommended radiographic views for knee evaluation include anteroposterior, lateral, and Merchant's views, with additional oblique views for specific assessments.
Weight-bearing radiographs should be obtained if osteoarthritis is suspected to assess for joint-space narrowing, subchondral sclerosis, osteophytes, and bony cysts.
Musculoskeletal ultrasonography allows for limited evaluation of effusions, cysts, tendons, ligaments, muscles, vasculature, and nerves, and can assess mechanical complaints.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge of knee pain evaluation and diagnosis with this quiz. Explore topics such as laboratory examinations, radiographic imaging, special tests, risk factors for knee osteoarthritis, and recommended diagnostic tools.