Common Diagnoses
Management & Recovery
Let's Test
Ouch!
Potpourri
100

What diagnosis is likely in a 16 y/o volleyball player that complains of anterior knee pain at the inferior border of the patella. This occurs often when she is jumping up during a game,

Patellar tendinitis 

100

Recommended therapy for a minor MCL strain

Rest, ice, NSAIDS, bracing, and physical therapy 

100

The test to assess for a posterior cruciate ligament tear 

Posterior Drawer Test


100

What is the most likely injury in a 17 y/o presenting two days after feeling a pop behind his thigh while running. NSAIDS have provided some relief. Resisted knee flexion has some weakness and reproduces pain. 

Acute Hamstring Strain

(Rest, ice, compression)

100

Inflammation of the sac that is anterior to the kneecap. Caused by a fall or direct blow to the anterior knee cap that can occur in wrestling or basketball

Prepatellar bursitis

- Rest, ice, elevation, NSAIDS (consider needle aspiration if no improvement)

200

What diagnosis is likely in a healthy 11 y/o active soccer player who reports a 2 week history of anterior right knee pain. No knee-joint effusion or ligamentous laxity. Exam shows a painful "bump" over the tibial tubercle and pain with resisted knee extension

Osgood-Schlatter disease (reassurance and supportive care) 

200

Imaging to help diagnose an ACL tear

MRI

- Most cases require surgical reconstruction to allow return to cutting and jumping sports 

200

The test to assess for a medial collateral ligament injury

Valgus stress test 


200

What is the most likely diagnosis in a 17 y/o cheerleader who landed awkwardly on her right leg and twisted her knee. She felt an immediate pop and noted an obvious knee deformity which resolved on its own when she straightened her leg. She had knee swelling immediately and is currently unable to ambulate. Apprehension test is positive. X-ray is normal.

Patellar dislocation (often have large knee effusion and cannot do full knee extension)

(Knee dislocation when 3 or more ligaments disrupted)

200

What is the bulge sign? 

Test for minor knee effusions

- With the knee extended, place hand above knee and place downward pressure on supra patellar pouch, displacing or "milking" fluid downward. Stroke downward on medial aspect of knee and apply medial pressure to force fluid into lateral area. Then, tap the knee just behind the lateral margin of patella and watch for fluid wave. 

300

Diffuse pain in the peripatellar or retropatellar portion in a 16 y/o cross country runner that is exacerbated with walking up or down the stairs, prolonged, sitting, squatting, or kneeling 

Patellofemoral syndrome

300

What is the best next management step for a 15 y/o boy who plays basketball and presents with 4 months of knee pain. Intermittent knee swelling and reports often times that knee will get "stuck" 

Crutches and radiographs (concern for osteochondritis desicans)

300

The test to assess for a lateral collateral ligamentous tear

Varus Stress Test 


300

What is the most likely injury in a 13 y/o girl who was playing soccer and was planting her foot to kick the ball when she felt a pop and her knee buckled? 

Anterior Cruciate Ligament Tear 

300

What injury is likely in 15 y/o girl with a 2 week history of bilateral lower extremity pain that developed after her first high school track season. She describes it as a deep ache over the medials aspect of both lower knees between knee and ankle the worsens with running. She has tenderness to palpation over the distal 2/3 of both posteromedial tibial surfaces and a normal knee exam. 

Medial tibial stress syndrome (shin splints)

- Traction on the periosteum by the calf muscles and repetitive bending loads across tibia 

- Rest, ice, compression, pre and post exercise stretching

400

What diagnosis presents in an 18 y/o cross country runner complaining of a "stinging" feeling localized over  her lateral femoral epicondyle during activity just proximal to the lateral knee joint. The pain is worse when she is running on indoor tracks or doing uphill drills. 

Iliotibial band bursitis 

400

Average recovery time after an ACL tear and surgery in the United States 

9-12 months
400

The test to assess for a medial meniscus tear

McMurry Test 



400

What is the most likely injury in a 16 y/o soccer player who fell after sustaining a kick to the lateral aspect of her knee? She is limping and know complains of pain on the medical aspect of her knee. Valgus stress testing is painful 

Medial collateral ligament (MCL) tear 

400

What diagnosis is most likely in a 2 y/o boy who presents several days after an episode of URI symptoms with fever, new limp, and a red, hot, and swollen knee?

Septic arthritis

500

What condition causes a piece of bone or cartilage to break off into the joint from necrosis of subchondral bone? Can occur either after a single injury or after repetitive trauma from overuse. Pain that worsens with activity, decreased range of motion, and joint popping/locking. 

Osteochondritis Dissecans 

500

What is the best sports schedule recommendation for an 11 year old boy with focal swelling and tenderness over the tibial tuberosities and resisted extension of the knees? Exam findings otherwise unremarkable

Spend at least 2-3 months per year away from structured sports

500

The most sensitive and specific test for an ACL tear 

Lachman test 


500

Most likely injury in a 13 y/o figure skater who lost step during a twisting maneuver and fell into knee hyperflexion.

Meniscal tear 

500

17 y/o long distance runner complaining of anterior and medial knee pain as well as a popping sensation of the knee with flexion. She also frequently experiences a catching or pseudo-locking sensation. This only occurs in her R knee. 

Plica syndrome (interarticular band of thickened, fibrotic tissue)

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