Pop Goes The Knee

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Pop Goes The Knee - Page #1

Author: Brett Bentley, MD Co Author #1: Siraj Abdullah, MD Patient Presentation: A 23 year-old Division 1 lineman was tackling an opposing tailback when he was struck at the lateral aspect of his right knee by the helmet of another player. The athlete heard a loud “pop” at impact, and remained down on the field of play. The athlete was evaluated by his training staff, and ultimately assisted off the field, unable to bear weight on the injured leg. There was an immediate effusion. <br>Of note, the patient had no preceding knee injury or surgeries. However, he had recently been evaluated by his athletic trainer for patellar tendonitis during the off-season. History: No other significant history. Physical Exam: LEFT knee <br>Range of Motion: intact (Extension 0 degrees, Flexion 135 degrees) <br>Strength: 5/5 with flexion and extension <br> <br>RIGHT knee <br>Range of Motion: exam limited secondary to pain <br>Right knee strength: 2/5 with knee extension <br>1+ Effusion <br>Palpation: <br>Medial and lateral joint lines of right knee – non-tender <br>Tibial tubercle, pes insertion, patella – <br>non-tender <br>Patella Medial and Lateral Facets – non-tender <br>Quadriceps tendon – non-tender <br>Patellar tendon - palpable defect at the inferior pole of the patella <br>Lachman and Anterior Drawer tests – negative <br>Posterior Drawer test – negative <br>Varus/Valgus Stress tests – negative <br>Straight Leg Raise – unable to perform Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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