knee injuries
DESCRIPTION
Knee injuries. Dr Abir Naguib. Knee pain is the most common musculoskeletal complaint (1/3) Source of significant disability Most prevalent in physically active individuals. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/1.jpg)
Knee injuries
Dr Abir Naguib
![Page 2: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/2.jpg)
•Knee pain is the most common musculoskeletal complaint (1/3)
•Source of significant disability
•Most prevalent in physically active individuals
![Page 3: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/3.jpg)
Differential diagnosis of knee pain is extensive
Accurate diagnosis can be achieved by localizing the anatomic site of pain &
patient’s age
![Page 4: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/4.jpg)
![Page 5: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/5.jpg)
![Page 6: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/6.jpg)
•Fracture•Ligament sprain•Tendon rupture•Meniscal tear•Patellar dislocation
Trauma
![Page 7: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/7.jpg)
History1.Pain characteristics:
Onset- location- duration- severity- quality- aggravating and relieving factors
2. Mechanical symptoms:
Pop
Locking
Giving way
![Page 8: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/8.jpg)
5. History of previous injury
3. Effusion:Timing and amount
4. Ability to continue playing
Exclude referred pain (hip injury)
![Page 9: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/9.jpg)
6. Mechanism of injury
Contact (Direction of
blow)
Non-contact(position of knee)
TwistingHyperextension
Deceleration
![Page 10: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/10.jpg)
Non-contact injury
![Page 11: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/11.jpg)
Hyperextension injury
![Page 12: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/12.jpg)
Examination:
Inspection: Swelling (location) Ecchymosis Atrophy
Palpation: Tenderness
ROM
Stability tests
Joint line
Ligament courseActive
passive
![Page 13: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/13.jpg)
Investigations
•RadiologicalX-ray, CT, MRI
•Aspiration(painful swollen joint)Clear yellowBloodBlood + fat droplets
•Arthroscopy
![Page 14: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/14.jpg)
MCL injury
![Page 15: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/15.jpg)
•CO:
Pop at time of injury
Pain , swelling (medial)
•OE:
Tenderness, swelling along ligament course
Valgus stress test
![Page 16: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/16.jpg)
LCL injury
Uncommon
Mechanism: blow to medial aspect knee
Varus force
Similar: (lateral)
Varus stress test
![Page 17: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/17.jpg)
ACL injury
PopImmediate swellingGiving way
![Page 18: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/18.jpg)
![Page 19: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/19.jpg)
Anterior drawer test
![Page 20: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/20.jpg)
Lachman test
![Page 21: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/21.jpg)
ACL
![Page 22: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/22.jpg)
PCL injury
![Page 23: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/23.jpg)
• CO: insecurity of knee
• OE: abrasion on proximal tibia (anterior)
mild swelling posterior drawer test
![Page 24: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/24.jpg)
Posterior sag sign
![Page 25: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/25.jpg)
PCL
![Page 26: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/26.jpg)
Meniscal tear
CO: Pain after quick twisting or squatting
Locking
OE: Swelling
Joint line tenderness
McMurray test
![Page 27: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/27.jpg)
Meniscal tear
![Page 28: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/28.jpg)
![Page 29: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/29.jpg)
Extensor mechanism injury
Quadriceps tendon rupture
Patellar tendon rupture
Patellar instability
![Page 30: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/30.jpg)
Quadriceps tendon ruptureAged, poorly conditioned
(descending,jumping)
CO: severe anterior knee pain
snap
fall suddenly
OE: swelling, tenderness (local)
Palpable gap proximal to patella
inability to extend knee
![Page 31: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/31.jpg)
![Page 32: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/32.jpg)
Quadriceps tendon rupture
![Page 33: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/33.jpg)
Patellar tendon rupture
young athletic patients
eccentric loading of quadriceps
OE: Swelling, tenderness palpable defect at distal pole patella Impaired knee extension
![Page 34: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/34.jpg)
![Page 35: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/35.jpg)
Patellar instabilitySubluxation – Dislocation
Mechanism: direct blow, forceful Q contraction
CO: Buckling Anterior knee painDifficulty extending knee
OE: Swelling (effusion-hemarthrosis) Tenderness medial patella
Apprehension signDD: history & X-ray
Young adults
![Page 36: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/36.jpg)
![Page 37: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/37.jpg)
![Page 38: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/38.jpg)
![Page 39: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/39.jpg)
In almost 90% of knee injuries an accurate diagnosis can be reached through thorough history taking and careful clinical examination.
![Page 40: Knee injuries](https://reader036.vdocuments.mx/reader036/viewer/2022062519/56815010550346895dbdf2d6/html5/thumbnails/40.jpg)
Thank you