Podcast
Questions and Answers
Which of the following findings is LEAST likely to be associated with knee osteoarthritis (OA)?
Which of the following findings is LEAST likely to be associated with knee osteoarthritis (OA)?
- Hypomobility of the tibiofemoral joint.
- Bony enlargement around the knee joint.
- Sudden onset of severe pain within hours of a non-contact injury. (correct)
- Morning stiffness lasting about 45 minutes.
A positive Lachman test and pivot-shift test are definitive indicators of a meniscal tear.
A positive Lachman test and pivot-shift test are definitive indicators of a meniscal tear.
False (B)
In the context of patellar tendinopathy, what specific aspect of the patella or patellar tendon typically exhibits tenderness upon palpation?
In the context of patellar tendinopathy, what specific aspect of the patella or patellar tendon typically exhibits tenderness upon palpation?
Inferior pole of the patella
The Noble compression test is a clinical assessment used to evaluate which specific condition affecting the knee: ______ Syndrome.
The Noble compression test is a clinical assessment used to evaluate which specific condition affecting the knee: ______ Syndrome.
Match the following knee injuries with their characteristic examination findings:
Match the following knee injuries with their characteristic examination findings:
What is the primary mechanism behind the pain associated with Osgood-Schlatter's disease?
What is the primary mechanism behind the pain associated with Osgood-Schlatter's disease?
Genu valgum is typically associated with Lateral Collateral Ligament (LCL) injuries.
Genu valgum is typically associated with Lateral Collateral Ligament (LCL) injuries.
What specific motion is typically limited during a patellar tilt test in individuals with patellofemoral pain (PFP) and mobility impairments?
What specific motion is typically limited during a patellar tilt test in individuals with patellofemoral pain (PFP) and mobility impairments?
In the context of Posterior Cruciate Ligament (PCL) injuries, the ______ test is a key physical examination maneuver used to assess the integrity of the PCL.
In the context of Posterior Cruciate Ligament (PCL) injuries, the ______ test is a key physical examination maneuver used to assess the integrity of the PCL.
Which of the following is the MOST indicative symptom of an acute ACL injury?
Which of the following is the MOST indicative symptom of an acute ACL injury?
Differentiation between a Grade II and Grade III LCL sprain is BEST determined by:
Differentiation between a Grade II and Grade III LCL sprain is BEST determined by:
In patellofemoral pain syndrome, pain is typically relieved by prolonged sitting and stair climbing.
In patellofemoral pain syndrome, pain is typically relieved by prolonged sitting and stair climbing.
Besides the tibial tubercle, what other anatomical structure is commonly affected in Osgood-Schlatter's disease?
Besides the tibial tubercle, what other anatomical structure is commonly affected in Osgood-Schlatter's disease?
The Ober test is used to assess the tightness of the ______ band, which is a common cause of lateral knee pain in runners.
The Ober test is used to assess the tightness of the ______ band, which is a common cause of lateral knee pain in runners.
Match the following knee conditions with the aggravating activity that is MOST characteristically associated with it:
Match the following knee conditions with the aggravating activity that is MOST characteristically associated with it:
Which of the following clinical tests and findings is MOST indicative of a lateral meniscal tear?
Which of the following clinical tests and findings is MOST indicative of a lateral meniscal tear?
A positive posterior drawer test always indicates a complete tear of the posterior cruciate ligament (PCL).
A positive posterior drawer test always indicates a complete tear of the posterior cruciate ligament (PCL).
In Pes Anserine Bursitis, which three tendons converge at the insertion point where the bursa is located?
In Pes Anserine Bursitis, which three tendons converge at the insertion point where the bursa is located?
Excessive knee ______ during a single-leg squat is a common finding in individuals with patellofemoral pain and movement coordination deficits.
Excessive knee ______ during a single-leg squat is a common finding in individuals with patellofemoral pain and movement coordination deficits.
A 20-year-old patient presents with anterior knee pain that worsens after prolonged sitting, known as the 'movie-goer's sign'. Which treatment strategy would be LEAST appropriate?
A 20-year-old patient presents with anterior knee pain that worsens after prolonged sitting, known as the 'movie-goer's sign'. Which treatment strategy would be LEAST appropriate?
Apley's compression test is primarily used to assess ligamentous stability in the knee.
Apley's compression test is primarily used to assess ligamentous stability in the knee.
During a varus stress test, at what degree of knee flexion is the Lateral Collateral Ligament (LCL) typically assessed in isolation?
During a varus stress test, at what degree of knee flexion is the Lateral Collateral Ligament (LCL) typically assessed in isolation?
The sensation of 'catching' or 'locking' in the knee is most closely associated with a ______ tear.
The sensation of 'catching' or 'locking' in the knee is most closely associated with a ______ tear.
Match the following knee conditions with the muscle group that is MOST important to strengthen as part of the rehabilitation process:
Match the following knee conditions with the muscle group that is MOST important to strengthen as part of the rehabilitation process:
What differentiates Pes Anserine bursitis from a medial meniscal tear?
What differentiates Pes Anserine bursitis from a medial meniscal tear?
A valgus force to the knee would likely result in an LCL injury.
A valgus force to the knee would likely result in an LCL injury.
What special test can assess compression of the IT band at the lateral femoral epicondyle?
What special test can assess compression of the IT band at the lateral femoral epicondyle?
The posterior drawer rest assesses the integrity of the ______.
The posterior drawer rest assesses the integrity of the ______.
Which of the following is a defining symptom of knee Osteoarthritis?
Which of the following is a defining symptom of knee Osteoarthritis?
A meniscal tear can occur from both contact and non-contact injuries.
A meniscal tear can occur from both contact and non-contact injuries.
The apprehension test is used to determine the stability of what structure?
The apprehension test is used to determine the stability of what structure?
The Lachman's test assesses the integrity of what ligament? ______
The Lachman's test assesses the integrity of what ligament? ______
Match the special test to the structure being assessed:
Match the special test to the structure being assessed:
The gold standard test for diagnosing a meniscal tear is?
The gold standard test for diagnosing a meniscal tear is?
Osgood-schlatter's disease is more common in adults.
Osgood-schlatter's disease is more common in adults.
When is pain typically present for a person with osgood-schlatter's?
When is pain typically present for a person with osgood-schlatter's?
If the Varus stress test is positive at 0 degrees, more than the LCL is injured. In this case, the ______ is also damaged.
If the Varus stress test is positive at 0 degrees, more than the LCL is injured. In this case, the ______ is also damaged.
Match the mechanism of injury to the likely instability:
Match the mechanism of injury to the likely instability:
A 65-year-old male experiences right knee pain, morning stiffness lasting 45 minutes, and crepitus. Examination reveals loss of knee flexion/extension and bony enlargement. Accessory motion testing shows tibiofemoral hypomobility. What is the MOST likely diagnosis?
A 65-year-old male experiences right knee pain, morning stiffness lasting 45 minutes, and crepitus. Examination reveals loss of knee flexion/extension and bony enlargement. Accessory motion testing shows tibiofemoral hypomobility. What is the MOST likely diagnosis?
A positive Ober test indicates tightness of the iliotibial band.
A positive Ober test indicates tightness of the iliotibial band.
A 22-year-old soccer player reports a non-contact injury to her left knee while decelerating and pivoting. She heard a 'pop,' experienced immediate swelling, and feels that her knee 'gives way' during certain activities. The Lachman and pivot-shift tests are positive. The 6-meter single-limb timed hop test is significantly less than 80% of her uninjured side. What specific injury is indicated by the positive Lachman and pivot-shift tests?
A 22-year-old soccer player reports a non-contact injury to her left knee while decelerating and pivoting. She heard a 'pop,' experienced immediate swelling, and feels that her knee 'gives way' during certain activities. The Lachman and pivot-shift tests are positive. The 6-meter single-limb timed hop test is significantly less than 80% of her uninjured side. What specific injury is indicated by the positive Lachman and pivot-shift tests?
A 14-year-old male actively involved in basketball reports anterior knee pain and a prominent, tender bump below his kneecap. Examination reveals localized tenderness and bony prominence at the ______.
A 14-year-old male actively involved in basketball reports anterior knee pain and a prominent, tender bump below his kneecap. Examination reveals localized tenderness and bony prominence at the ______.
Match the following knee injury tests with the injuries they are MOST commonly used to diagnose:
Match the following knee injury tests with the injuries they are MOST commonly used to diagnose:
Flashcards
Knee Osteoarthritis
Knee Osteoarthritis
Progressive knee joint deterioration.
ACL Injury
ACL Injury
Ligament rupture from deceleration & pivoting.
Patellar Tendinopathy
Patellar Tendinopathy
Anterior knee pain from repetitive jumping.
ITB Syndrome
ITB Syndrome
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Medial Meniscal Tear
Medial Meniscal Tear
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Osgood-Schlatter's Disease
Osgood-Schlatter's Disease
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Pes Anserine Bursitis
Pes Anserine Bursitis
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LCL Sprain/Tear
LCL Sprain/Tear
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Patellofemoral Pain
Patellofemoral Pain
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PCL Injury
PCL Injury
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Meniscus
Meniscus
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Tendon
Tendon
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Ligament
Ligament
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Bursa
Bursa
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Knee Extension
Knee Extension
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Knee Flexion
Knee Flexion
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Effusion
Effusion
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Hemarthrosis
Hemarthrosis
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Crepitus
Crepitus
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ACL Injury
ACL Injury
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Knee Osteoarthritis
Knee Osteoarthritis
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Patellofemoral Pain (PFP)
Patellofemoral Pain (PFP)
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Iliotibial Band (ITB) Syndrome
Iliotibial Band (ITB) Syndrome
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Lateral Meniscal Tear
Lateral Meniscal Tear
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Osgood-Schlatter's Disease
Osgood-Schlatter's Disease
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Pes Anserine Bursitis
Pes Anserine Bursitis
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Lateral Collateral Ligament (LCL) Sprain
Lateral Collateral Ligament (LCL) Sprain
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Patellofemoral Pain Syndrome (PFPS)
Patellofemoral Pain Syndrome (PFPS)
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Posterior Cruciate Ligament (PCL) Sprain/Tear
Posterior Cruciate Ligament (PCL) Sprain/Tear
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Study Notes
- These clinical case studies focus on knee-related injuries and conditions
- Each case includes a brief history, physical examination findings, and the most likely diagnosis, along with the reasoning behind it
Case Study 1: Knee Osteoarthritis (OA)
- A 65-year-old male reports insidious onset of right knee pain over several months
- Morning stiffness lasts about 45 minutes and improves with movement
- Pain is worsened by prolonged standing and walking
- Crepitus is present with knee movement
- Loss of knee flexion and extension range of motion
- Bony enlargement around the knee joint upon palpation
- Hypomobility in tibiofemoral joint accessory motion testing
Case Study 2: Anterior Cruciate Ligament (ACL) Injury
- A 22-year-old female soccer player describes a non-contact injury to her left knee while decelerating and pivoting
- She heard a "pop" at the time of injury and experienced immediate swelling
- Reports feeling like her knee "gives way" during activities
- Positive Lachman test and pivot-shift test
- Injured leg scores significantly less than 80% of the uninjured side on the 6-meter single-limb timed hop test
Case Study 3: Patellar Tendinopathy (Jumper's Knee)
- A 17-year-old male basketball player has anterior knee pain worsening over months
- Pain is located below the kneecap
- Pain is aggravated by jumping, squatting, and kneeling
- Tenderness upon palpation over the inferior pole of the patella and the patellar tendon
- Experiencing pain with active knee extension against resistance
Case Study 4: Iliotibial Band (ITB) Syndrome
- A 35-year-old female runner reports lateral right knee pain after running for about 10 minutes
- Pain is a burning sensation on the outside of her knee around 30 degrees of flexion during running
- Pain eases with rest
- Tenderness upon palpation over the lateral femoral condyle
- Positive Noble compression test confirms diagnosis
Case Study 5: Medial Meniscal Tear
- A 50-year-old male with a history of twisting injury to his left knee, reports intermittent pain along the medial joint line
- Reports a "catching" sensation in his knee, especially with twisting movements
- McMurray's test with external rotation and valgus stress reproduces medial knee pain, along with a palpable click
Case Study 6: Osgood-Schlatter's Disease
- A 14-year-old male basketball player has anterior knee pain and a prominent, tender bump below his kneecap
- Pain is aggravated by running and jumping
- Examination reveals localized tenderness and bony prominence at the tibial tuberosity
- Knee range of motion is full, but resisted knee extension elicits pain
Case Study 7: Pes Anserine Bursitis
- A 48-year-old female reports pain on the medial aspect of her knee, about 2 inches below the joint line
- Pain is worse at night and with stair climbing
- Palpation in this area reveals tenderness
- Tenderness with resisted knee flexion and hip adduction
- Has a mild genu valgum
Case Study 8: Lateral Collateral Ligament (LCL) Sprain/Tear
- A 28-year-old male sustained a direct blow to the lateral aspect of his left knee during a football game
- Reports pain and instability on the outside of his knee
- Varus stress testing at 0 and 30 degrees of knee flexion reveals increased lateral joint line opening compared to the uninjured side
Case Study 9: Patellofemoral Pain (PFP) with Mobility Impairments
- A 30-year-old female presents with insidious onset of anterior knee pain, localized to the retropatellar area
- Pain is exacerbated by squatting, stair climbing, and prolonged sitting ("movie-goer's sign")
- Crepitus with patellofemoral joint movement
- Patellar tilt test shows limited lateral patellar glide
Case Study 10: Posterior Cruciate Ligament (PCL) Injury
- A 25-year-old male athlete reports a posterior blow to his right knee during a tackle
- He denies hearing a pop, but reports immediate pain and difficulty with weight-bearing
- Tibia sags posteriorly relative to the femur compared to the uninjured side when supine with hips and knees flexed to 90 degrees
Case Study 11: Anterior Cruciate Ligament (ACL) Injury
- A 20-year-old male college basketball player reports sudden onset of right knee pain after landing awkwardly from a jump
- He describes immediate, severe pain and inability to continue playing
- Significant knee swelling (effusion within 0 to 12 hours of injury)
- Unable to fully extend his knee due to pain and swelling
- Positive Lachman test
- Reports a history of giving-way episodes
Case Study 12: Knee Osteoarthritis (OA)
- A 55-year-old female presents with chronic left knee pain worsening over the past year
- Reports pain with walking, particularly going up and down stairs
- Stiffness after sitting for prolonged periods takes about 20 minutes to subside
- Limited range of motion in knee flexion and extension
- Crepitus with knee movement
- Pain at end ranges of motion
- Palpable deformity of the tibiofemoral joint noted
Case Study 13: Patellofemoral Pain (PFP) with Movement Coordination Deficits and Mobility Impairments
- A 16-year-old female soccer player reports anterior knee pain that is worse with running, jumping, and prolonged sitting
- Denies any specific injury
- Tenderness to palpation of the patella, particularly on the medial border
- During a single-leg squat, the examiner observes excessive knee valgus
- The patellar tilt test shows limited lateral patellar glide
Case Study 14: Iliotibial Band (ITB) Syndrome
- A 30-year-old male runner presents with lateral knee pain, consistently after running approximately 3 miles
- The pain is sharp and located over the lateral femoral epicondyle
- Tender upon Palpation in this area, especially with the knee flexed to 30 degrees
- Positive Ober test indicates tightness of the iliotibial band
Case Study 15: Lateral Meniscal Tear
- A 40-year-old male reports a twisting injury to his left knee during a touch football game
- Felt immediate pain along the lateral joint line
- Reports occasional catching and locking sensations, particularly with twisting movements
- Apley's compression test reproduces his lateral knee pain and elicits a click with rotation
Case Study 16: Osgood-Schlatter's Disease
- A 13-year-old male middle school basketball player presents with anterior knee pain, a noticeable, firm, and tender prominence at his tibial tubercle
- Pain is aggravated by jumping and squatting during basketball practice
- Resisted knee extension is painful
- Palpation over the tibial tubercle elicits significant tenderness
Case Study 17: Pes Anserine Bursitis
- A 58-year-old female reports pain on the medial aspect of her right knee, approximately one inch below the joint line
- The pain is often worse with activities like getting in and out of a car and with direct pressure
- Localized tenderness to palpation in this area
- Resisted knee flexion and internal rotation do not significantly provoke her pain
- She has a mild genu valgum
Case Study 18: Lateral Collateral Ligament (LCL) Sprain (Grade II)
- A 26-year-old male sustained a varus stress to his left knee during a skiing accident
- Reports pain and a feeling of instability on the outside of his knee
- Varus stress testing at 30 degrees of knee flexion reveals increased lateral joint line laxity compared to the uninjured side, but the test is negative at 0 degrees
Case Study 19: Patellofemoral Pain Syndrome (PFPS)
- A 32-year-old female presents with insidious onset of anterior knee pain, describes as a deep ache behind her patella
- The pain is significantly aggravated by prolonged sitting at work and going down the stairs
- Physical examination reveals crepitus with patellofemoral joint movement
- The patellar apprehension test is negative
Case Study 20: Posterior Cruciate Ligament (PCL) Sprain/Tear
- A 28-year-old male athlete reports falling onto his right knee with his foot plantarflexed
- Experienced immediate pain in the posterior aspect of his knee and now has difficulty fully bending his knee
- Positive posterior drawer test, and there is no noticeable posterior sag with the tibia in a gravity-dependent position
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