The Acutely Injured Knee – SAQ’s

A 76-year-old man, tripped on stairs falling onto the outer aspect of his right knee. On examination, tender laterally, limited weight-bearing.

a) What abnormality(ies) is/are shown on the X-ray?

b) What other knee injuries are commonly associated with this fracture?

Image 1 – Courtesy of the author

A 65-year-old man tripped while stepping up onto a bus. He reports pain over the anterior knee and difficulty in walking, especially when climbing steps.

a) What abnormality(ies) is/are shown on the X-ray?

b) What further investigation could be performed if the diagnosis is not clear clinically ?

Image 3 – Courtesy of the author

A 65-year-old lady fell onto the edge of a stool, hitting lateral aspect of her left knee. Her knee is swollen, bruised and tender over lateral joint line.

What abnormality(ies) is/are seen on the x-ray?

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A 16-year-old boy presents after falling from a motorcross bike onto his left knee. Very swollen and tender over the patella. He is unable to extend the knee or perform a straight-leg raise.

What abnormality(ies) is/are seen on the X-ray? (3 marks)

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A 55-year-old man with right leg weakness secondary to multiple sclerosis fell against the side of a bath, hitting his right knee. There is no effusion. He is tender over the lateral joint line /proximal fibula.

a. What abnormality(ies) is/are shown on the x-ray?

b. What bony and non-bony injuries can be associated with this?

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A 23-year-old female who fell from a horse onto her left leg, stressing the knee into valgus on landing. She has a painful, swollen left knee and is unable to weight-bear.

a) What radiographic abnormality(ies) is/are shown on the x-ray?

b) What is the orthopaedic injury?

c) List the radiographic signs of this injury that may be seen on the AP and the lateral knee radiograph.

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A 53-year-old woman was playing football with her son when she twisted and fell onto her right knee during a tackle. She is partially weight-bearing. There is a large effusion, generally tender joint line. Ligament examination is not possible due to pain.

a) What is the injury seen on the x-ray?

b) what soft tissue injury is associated with it?

c) What is the management of this injury?

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A 15-year-old boy sustained a twisting injury during a rugby tackle, resulting in a painful knee and thigh. There is no joint tenderness, but knee movement is painful.

What abnormality(ies) is/are shown on the x-ray?

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A 18-year-old boy fell while skiing. He is partially weight-bearing and is unable to fully extend his knee. There is a large effusion and a generally tender joint line.

a) What is/are the radiographic abnormalities?

b) What associated non-bony injury does this represent?

c) What investigation would help to confirm this?

Image 17 – Courtesy of the author

A 52-year-old man with a history of knee surgery following an RTA fell down the stairs onto his knee. He now reports increased pain and limited ability to weight-bear.

a) What is the injury shown on the radiograph?

b) The patient feels better after analgesia and wants to go home. What would you advise him?

Image 19 – Courtesy of the author