Question 1

A previously healthy patient reports a sensation of one knee locking or feeling like it will give way when descending stairs. The patient has no recollection of injury to the knee and denies pain. What is the most likely treatment for this disorder?

A) Conservative management with RICE and activity modification
B) Immediate referral to an orthopedic surgeon for possible repair
C) Intraarticular injections of corticosteroids three times yearly
D) Restricting participation in sports and strenuous workouts indefinitely

A

Accepted Answer

The patient's symptoms suggest a possible meniscal tear or other soft tissue injury, which can often be managed conservatively with rest, ice, compression, and elevation (RICE) and activity modification. Referral to an orthopedic surgeon or injections of corticosteroids may be considered if conservative management is not effective or if a more significant injury is suspected, but these options are not typically the first-line treatment for this type of presentation. Restricting participation in sports and strenuous workouts indefinitely is not necessary unless the injury is severe or symptoms persist despite conservative management.

Question 2

A high school soccer player sustains a knee injury when kicked on the lateral side of the knee by another player. The provider notes significant swelling of the knee, with pain at the joint line on the medial aspect of the knee. What will the provider do to treat this injury?

A) Instruct about RICE management and follow up in 1 week
B) Refer for a same-day orthopedic consultation
C) Schedule a magnetic resonance imaging (MRI) exam
D) Splint the knee and refer for orthopedic consultation in 1 to 2 weeks

B

Accepted Answer

The combination of significant swelling and pain at the joint line on the medial aspect of the knee suggests a potential ligamentous injury, such as a tear of the medial collateral ligament (MCL). Referring for a same-day orthopedic consultation is the best course of action to ensure prompt and appropriate management of the injury. RICE management, MRI, and splinting may still be necessary, but should be determined by the orthopedic specialist.

Question 3

Which maneuver during a physical examination is used to assess the anterior cruciate ligament (ACL)?&#10;A) Anterior drawer test&#10;B) Posterior drawer test&#10;C) Valgus stress on knee joint&#10;D) Varus stress on knee joint

Accepted Answer

The anterior drawer test is used to assess the anterior cruciate ligament (ACL) by applying a forward force on the tibia to see if it translates abnormally in relation to the femur. The other choices (B, C, D) are used to assess other ligaments or stability of the knee joint.

Deck 162: Knee Pain