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97 Cards in this Set

  • Front
  • Back
Can plain film be normal even when there is extensinve soft tissue injury to the knee
What is the imaging modaility of choice for occult bone injuries and soft tissue injuries of the knee
What are 3 clues on MR that there is pathology involving a ligament
non-visualization, disruption, increased signal.
What are 6 possible views of the knee
Inter and external oblique
tunnel (AKA knotch)
Axial ( AKA; skyline, tangential, sunrise, merchant view)
AP anatomy of the knee
Lateral anatomy of the knee
What is are two important landmarks that lay underneath the quadraceps femoris tendon
suprapatellar fat body
suprapatellar bursa (underneath the fat pad)
What does the quadriceps femoris tendon attach to
the patella
What is the ligment that inferiorly attaches to the patella
the patellar ligament
What fat pad is underneath the patellar ligament
the infrapatellar fat pad.
What is another name for the infrapatellar fat pad
hoffas fat pad
What does the patellar ligament insert on
the tibial tuberosity
What does the ACL arise from
lateral femoral condyle (top)
What does the ACL insert into
anterior to the medial tibial spine
Where does the PCL arise from
the medial femoral condyle (top)
Where does the PCL insert
posterior to the lateral tibial spine
Where does anterior an posterior part of the the name of ACL and PCL come from
there location on the tibia
What is another name for the medial collateral ligament
tibial collateral ligament
Where does the MCL arise from and insert
the medial femoral condyle and inserts into the medial condyle of the tibia
Are the deep fibers of the MCL bound to the articular capsule of the knee
yes, (this is my MCL injuries are almost always associated with medial meniscus injuries)
What is another name for the LCL
the fibular collateral ligament

Note the the Lateral collateral ligament is part of the lateral capsular complex which is the LCL, iliotibial band and bicep femoris
Where does the lateral collateral ligament insert and attach
attach: lateral femoral condyle
insert: head of the fibula
What are 2 ST clues to injury of the knee
joint effusions
Where do joint effusions of the knee occur
above the patellar and posterior to the quadricepts tendon
What happens when the suprapatellar effusion becomes large enough
they will tilt the superior portion of the patella forward.
What happens to the clear space above the patellar when there is a joint effusion
the clear space (fat) becomes obliterated and is replaced with a soft tissue density area that fills it and bulges the adjacent ST outward
What else besides an effusion will cause the patella to tilt forward
rupture of the quadriceps femoris tendon
What is the difference in appearance of a ruptured quadriceps tendon and effusion
the fat pad will not be obliterated in a rupture of the tendon
What is the cause of a lipohemarthrosis
fat exiting the marrow cavity 2/2 a fx
What is the most common cause of a lipohemarthrosis of the knee
a tibial plateau fx
Does fat float on the blood
What is a important technical aspect of X-ray postioning to see a lipohemarthrosis
requires a horizontal beam
What does a fat fluid level look like
there is soft tissue density with the more lucent fat density on top
Can there be a triple level lipohemarthrosis
yes from cells layering out
What are the 3 categories of distal femur fx
supracondylar, condylar, intercondylar
What is the MCC of a distal femoral fx
axial loads (MVA, falls)
What are common associated injuries of distal femur fx
ligament injuries, vascular, tibial plateau fx
What is the MC ligament injured from a distal femur fx
Are dislocations of the knee common
How are tibiofemoral dislocations of the knee described
by the resting place of the tibia
What are two dislocations of the knee
tibiofemoral/patellar femoral
Which way is the patellar usually dislocated
Why is the patellar more commonly displaced lateral
the lateral femoral condyle is more shallow
What is more common a subluxation of the the knee or dislocaiton
What is more common an anterior or posterior dislocation of the tibia
What are two diseases of the patella
osgood schlatter and sinding-larsen-johannson disease
What are some similarities between these diseases
repetitive trauma
Where does Sinding-Larsen-Johansson disease occur
proximal end of patellar tendon
Where does OS disease occur
the distal end of the patella tendodn ( tibial tuberosity)
Are OS and SLJ diseases clinical diagnoses
yes (local pain and tenderness)
Is imaging needed to diagnose OS and SLJ diseases
What is the cause fo SLJ disease
traction stress on the proximal end of the patellar ligament (inferior pole of the patella)
What are the imaging findings of SLJ disease
fragmentation, osteophytes and STS on inferior pole of the patellla

heterotopic calcification of the patella tendon
What is Osgood-schlatter disease
a traction apophysitis (osteochondritis) 2/2 repetitive stress injury at the site of the tibial tuberosity
What percent of OS is bilateral
25-50 %
What are the imaging findings of OS disease
fragmentation, STS
If there are radiographic findings consistent with either SLJ and OS disease is it diagnostic
no, if the pt doesnt have the symptoms
What is the unhappy triad of athletes
Medial meniscus
Where is the seperate ossification center of a bipartite patella located
superolateral pole
What % of bipartite patellas are bilateral
Describe the margins of a bipartite patella
smooth and corticated
What does a patella fx that occurs as a result of a direct blow generally look like
comminuted with articular cartilage damage
What does a patellar fx as a result of an indirect fx look like
articular cartilage is spared and these are avulsion injuries
What is the main cause of an indirect patellar fx
avusion 2/2 jumping
Are most patellar fx transverse or vertical
What additional finding do you expect to see in a pt with a patella fx
an effusion
What happens to the fragments of the patella following a complete transverse fx
they become distracted
What is the most common fx of the proximal tibia
tibial plateau fxs
What is more common the lateral or medial plateau
What is the MC mechanism of a tibial plateau fx
a compressive force of the femoral condyles (fall from height) or can be from a car bumper
What is the general rule of thumb with fractures of the tibial plateau and ligaments
there is commonly injury to the opposite ligament
What causes a depressed fx of the tibial plataue
depressed fx are caused by downward force by the condyle of the femur
What are 3 types of osteochondral injuries
osteochondral fractures
osteochondral dissecans
spontaneous osteonecrosis
Are osteochondral injuries usually acute and sports related
What osteochondral areas are most often involved in osteochondral injuries
the femoral condyles, tibial plateaus, patella
What often occurs following an osteochondral fx
a loose body fragment
What is an osteochondral fx often confused with
osteochondritis dissecans
What is the clinical SS of an osteochondral fx
sudden onset of severe pain
What is the demographic of a pt with osteochondritis dissecans
adolescent and young adult males
Is osteochondritis dissecans a chronic condition
Does osteochondritis dissecans always affect bone and cartilage
no, it can be both or just cartilage
Where is the classic location for osteochondritis dissecans
lateral aspect of the medial condyle
What is the MC cause of a loose body
osteochondritis dissecans
If there is an unstable fragment does it almost always require surgery
Where is the lateral aspect of the medial femoral condyle
centrally located
What is SONK stand for
spontaneous osteonecrosis
What is the typical onset for SONK
older adult with acute onset of pain
Does osteochondritis dissecans occur on the weight bearing surface of the medial condyle
Does SONK occur on the weight bearing surface of the medial femoral condyle
What type of fracture is SONK
insufficiency fx (makes sense it happens in older people)
Is SONK acute in onset
What are bony clues to a ST injury of the knee
avulsion of intercondylar eminence, segond fx, avulsion of the proximal posterior tibia
What is avulsion of the intercondylar eminence associated with
tear of the ACL
What is a clue that there is a MCL ligament tear
widening of the medial portion of the knee joint space
What is a segund fx
an avulsion fx of the lateral boder of the proximal tibia
What are segond fx associated with
ACL tears (100%)
medial mensiscus (75%)
What is an avulsion fx of the posterior portion of the proximal tibia
PCL tear