Meniscus and ligament knee injuries - Revision history

Rossdonaldson1: /* References */

2019-05-10T01:33:00Z

References

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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
			[[Category:Sports Medicine]]

Mholtz at 18:14, 17 November 2017

2017-11-17T18:14:56Z

← Older revision		Revision as of 18:14, 17 November 2017
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	*A sensation of popping at the time of injury suggests ligamentous injury, probably complete rupture of a ligament (third-degree tear)		*A sensation of popping at the time of injury suggests ligamentous injury, probably complete rupture of a ligament (third-degree tear)
	*Episodes of giving way are consistent with some degree of knee instability and may indicate patellar subluxation or ligamentous rupture		*Episodes of giving way are consistent with some degree of knee instability and may indicate patellar subluxation or ligamentous rupture
			*Rapid onset (within two hours) of a large, tense effusion suggests rupture of the anterior cruciate ligament or fracture of the tibial plateau with resultant hemarthrosis, whereas slower onset (24 to 36 hours) of a mild to moderate effusion is consistent with meniscal injury or ligamentous sprain. Recurrent knee effusion after activity is consistent with meniscal injury.
	~~===Effusions===~~
	Rapid onset (within two hours) of a large, tense effusion suggests rupture of the anterior cruciate ligament or fracture of the tibial plateau with resultant hemarthrosis, whereas slower onset (24 to 36 hours) of a mild to moderate effusion is consistent with meniscal injury or ligamentous sprain. Recurrent knee effusion after activity is consistent with meniscal injury.

	{{ACL clinical features}}		{{ACL clinical features}}
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	==Disposition==		==Disposition==
	*~~Outpatient ortho referral~~		*Discharge with orthopedic surgery follow-up

	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>

	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Rossdonaldson1: /* See Also */

2017-11-09T07:22:09Z

Rossdonaldson1: /* Clinical Features */

2017-11-09T06:40:08Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	History of locking episodes suggests a meniscal tear. A sensation of popping at the time of injury suggests ligamentous injury, probably complete rupture of a ligament (third-degree tear). Episodes of giving way are consistent with some degree of knee instability and may indicate patellar subluxation or ligamentous rupture.		*History of locking episodes suggests a meniscal tear
			*A sensation of popping at the time of injury suggests ligamentous injury, probably complete rupture of a ligament (third-degree tear)
			*Episodes of giving way are consistent with some degree of knee instability and may indicate patellar subluxation or ligamentous rupture

	===Effusions===		===Effusions===

Rossdonaldson1: /* Management */

2017-11-09T06:38:26Z

Management

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	*Knee brace, ice, elevation, ambulation as soon as comfortable		*Knee brace, ice, elevation, ambulation as soon as comfortable
	**Full knee immobilization generally not indicated for single ligament injuries		**Full knee immobilization generally not indicated for single ligament injuries
	*~~Ortho~~ referral
			==Disposition==
			*Outpatient ortho referral

	==See Also==		==See Also==

Rossdonaldson1: /* Evaluation */

2017-11-09T06:37:51Z

Evaluation

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	==Evaluation==		==Evaluation==
	[[File:Segond.jpg\|thumb\|Segond Avulsion Fracture (ACL tear)]]		[[File:Segond.jpg\|thumb\|Segond Avulsion Fracture (ACL tear)]]
	*Knee ~~XR to rule~~-~~out fracture~~		{{Ottawa knee rules}}
			{{Knee x-rays}}

			===Diagnosis of Ligamentous and/or Meniscus Injury===
	*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling		*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling
	**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis		**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis
	Arthrocentesis to differentiate between simple effusion and Simple joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury
	**Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus
	**An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.

	==Management==		==Management==

Rossdonaldson1: /* Background */

2017-11-09T03:52:17Z

Background

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	==Background==		==Background==
	*Anterior Cruciate Ligament		{{Knee ligaments}}
	**Limits anterior translation of tibia
	**75% of all hemarthroses are caused by disruption of ACL
	*Posterior Cruciate Ligament
	**Limits posterior translation of tibia
	**Isolated injuries are rare
	*Medial Collateral Ligament
	**Provide restraint against valgus (outward) stress
	*Lateral Collateral Ligament
	**Provide restraint against varus (inward) stress

	==Clinical Features==		==Clinical Features==

Ashjav: /* Evaluation */

2017-11-05T19:55:11Z

Evaluation

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	*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling		*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling
	**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis		**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis
	*Arthrocentesis to differentiate between simple effusion and ~~hemearthrosis:~~		Arthrocentesis to differentiate between simple effusion and Simple joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury
	*Simple joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury		**Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus
	*Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus		**An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.
	*An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.

	==Management==		==Management==

Ashjav: /* Evaluation */

2017-11-05T19:54:22Z

Evaluation

← Older revision		Revision as of 19:54, 5 November 2017
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	*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling		*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling
	**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis		**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis
	*Arthrocentesis to differentiate between simple effusion and hemearthrosis: ~~simple~~ joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury. Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus. An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.		*Arthrocentesis to differentiate between simple effusion and hemearthrosis:
			*Simple joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury
			*Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus
			*An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.

	==Management==		==Management==

Ashjav: /* Evaluation */

2017-11-05T19:52:57Z

Evaluation

← Older revision		Revision as of 19:52, 5 November 2017
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	*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling		*Normally clinically diagnosed initially or referred for re-exam in 4-5 days after decrease of swelling
	**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis		**Primary medical doctor or orthopedics may later use MRI for definitive diagnosis
			*Arthrocentesis to differentiate between simple effusion and hemearthrosis: simple joint effusion produces clear, straw-colored transudative fluid, as in a knee sprain or chronic meniscal injury. Hemarthrosis is caused by a tear of the anterior cruciate ligament, a fracture or, less commonly, an acute tear of the outer portion of the meniscus. An osteochondral fracture causes hemarthrosis, with fat globules noted in the aspirate.

	==Management==		==Management==

← Older revision		Revision as of 07:22, 9 November 2017
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	==See Also==		==See Also==
	*[[Knee Diagnoses]]		*[[Knee Diagnoses]]
			*[[Acute knee injury]]

	==References==		==References==
	<references/>		<references/>
	[[Category:Orthopedics]]		[[Category:Orthopedics]]