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Self-Assessment Questions

Orthopaedic Surgery

Acute Knee Injuries: Review Questions

Mark D. Miller, MD

Dr. Miller is an Associate Professor, Department of Orthopaedics, University of Virginia, Charlottesville, VA.


Choose the single best answer for each question.

1. A 21-year-old female basketball player has a tender, swollen knee that was injured when she landed awkwardly. She reports that her knee "gave out" and that she heard a "pop" and was unable to return to play. Which of the following is the most likely diagnosis?
  1. Anterior cruciate ligament (ACL) injury
  2. Knee contusion
  3. Lateral collateral ligament injury
  4. Medial collateral ligament (MCL) injury
  5. Posterior cruciate ligament (PCL) injury
Click here to compare your answer.


2. A 12-year-old boy injures his knee in a football game. His knee is tender and swollen, and he is unable to walk from the field. Physical examination shows a tense effusion and negative Lachman and drawer tests, but the patient has demonstrable laxity with valgus stress testing. Plain radiographs are normal for the patient’s age. Which of the following studies is the most appropriate to obtain at this point?

  1. Computed tomography scan
  2. Functional testing
  3. KT-1000 arthrometer testing
  4. Magnetic resonance imaging
  5. Stress radiography
Click here to compare your answer.


3. A 30-year-old construction worker trips and lands on his knee with his foot plantar flexed. He has a moderate effusion and reports that his knee feels "loose." Which of the following is the most likely diagnosis?

  1. ACL injury
  2. Knee contusion
  3. Lateral collateral ligament injury
  4. MCL injury
  5. PCL injury
Click here to compare your answer.


  4. Which of the following is the recommended treatment for a patient with an isolated MCL injury?
  1. Acute repair/reconstruction
  2. Delayed repair/reconstruction
  3. Hinged knee brace for 6 to 8 weeks
  4. Knee immobilizer for 6 to 8 weeks
  5. Symptomatic treatment only
Click here to compare your answer.


5. A 25-year-old man is injured in a car accident and reports that his knee hit the dashboard. Physical examination reveals a moderate effusion, apparent increased excursion with Lachman testing, significant (3+) posterior drawer, and increased external rotation of his foot with the knee in both 30 and 90 degrees of flexion. The remainder of the examination of his knee is unremarkable. Which of the following is the most likely diagnosis?

  1. Combined ACL and PCL injury
  2. Combined ACL and posterolateral corner injury
  3. Combined PCL and posterolateral corner injury
  4. Isolated ACL injury
  5. Isolated PCL injury
Click here to compare your answer.


6. An 18-year-old female soccer player sustains a twisting injury and reports that her knee "popped out of place." Physical examination shows a moderate effusion, but results of her ligamentous examination and anteroposterior and lateral radiographs are normal. Which of the following is the most likely diagnosis?

  1. ACL injury
  2. Growth plate (physeal) injury
  3. Patellar dislocation
  4. Patellar tendon ruptur
  5. Tibial eminence fracture
Click here to compare your answer.
 

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