Injuries of Knee, Leg and Foot MCQs

From the history, the person has stress fractures. Stress fracture is sometimes not seen on x-ray in early stages. Hence we need further investigations to confirm our diagnosis. For suspected stress fracture in one site, the investigation of choice is MRI. But for B/L stress fractures or multiple stress fractures, bone scan is recommended over MRI as it is easy, effective and economical. Reference- Rockwood and green adult fracture 8ᵗʰ edition, page-653

Stress fracture occurs due to abnormal loading of a normal bone. This is classically seen in individuals who perform repetitive, strenuous activities that he/she is not accustomed to. The most common site of stress fracture is Tibia followed by 2 nd metatarsal (March Fracture) Reference- Rockwood and green adult fracture 8 th edition, page-652

Pigmented villonodular synovitis: Pigmented villonodular synovitis(PVNS) is a rare benign disease of the synovial membrane which is characterised by hypervascular neoplastic proliferation of the synovium with deposition of macrophages, multinucleated giant cells and hemosiderin. Knee joint is most commonly involved joint. On arthroscopy typical brownish pigmentation of synovium is seen due to deposition of hemosiderin pigment. Two varieties have been described: Diffuse variety and localized nodular variety. Chances of recurrence are higher in diffuse variety. Low dose external beam radiotherapy and arthroscopic/open synovectomy have been tried with varying success for the treatment. Malignant transformation has been reported but very rare. Reference: Fundamentals of Ortho Mohindra and Jain, Page no. 268.

Locking is the phenomenon in which the patient is unable to fully extend the knee due to intra articular block by a torn meniscus. Hence, when the patient has locking of knee, it means he/ she has sustained a meniscus injury. Locking is most common in bucket-handle type of longitudinal tears of meniscus, where the inner segment of the meniscus is caught in the intercondylar notch and cannot return to its former position. Reference - Manish Kumar Varshney 1 st edition page no 901.

Both the anterior and posterior cruciate ligamnets are intracapsular but extrasynovial. In the knee, the extra capsular structures are the MCL and LCL The Intracapsular structures are Intrasynovial - Menisci Extrasynovial - ACL, PCL Reference: BD Chaurasia's Human Anatomy-Volume 1, Edition 6th, page no. 144.

Given below are the common named bursitis of the body. Prepatellar bursitis -Housemaid’s knee Infrapatellar bursitis- Clergyman’s knee Olecranon bursitis -Student’s elbow Ischial bursitis -Weaver’s bottom On lateral malleolus -Tailor’s ankle On great toe –Bunion Reference - Maheshwari 4th /e p. 292

Given below are the common named bursitis of the body. Prepatellar bursitis- Housemaid's knee Infrapatellar bursitis- Clergyman’s knee Olecranon bursitis -Student’s elbow Ischial bursitis- Weaver’s bottom On lateral malleolus -Tailor’s ankle On great toe- Bunion Reference - Maheshwari Essential Orthopedics 4th /e p. 292

PCL tears are typically produced by external trauma such as the classic “dashboard injury” resulting from a posteriorly directed force on the anterior aspect of the proximal tibia with the knee flexed and foot plantar flexed. In athletics, the typical mechanism of isolated PCL tears is a direct blow to the anterior tibia or a fall onto the knee with the foot in a plantar flexed position. Football, soccer, rugby and skiing are among the sports with the highest incidence of PCL tears. Non-contact mechanisms, such as hyperflexion, are less common. Reference - Manish Kumar Varshney 1 st edition page no 888