Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification. X-ray of the knee joint – if bony involvement is suspected; anterior and posterior cruciate ligament rupture. Sonography (ultrasound examination) – if meniscus lesion, ligament injuries are suspected. Doppler sonography (ultrasound examination … Knee Injuries: Diagnostic Tests
Surgical therapy is indicated for complex ligamentous ruptures, bony involvement, or severe instability of the knee joint. Meniscal Injuries In cases of meniscal damage with severe symptoms, arthroscopy (arthroscopy of the joint) with removal of the affected portions or (depending on the extent of damage) removal of the entire meniscus is usually performed (see “Meniscal … Knee Injuries: Surgical Therapy
The medical history (history of the patient) represents an important component in the diagnosis of knee injuries. Family history Is there a frequent history of bone/joint disease in your family? Social history What is your profession? Current medical history/systemic history (somatic and psychological complaints). Are you experiencing pain? If yes, when does the pain occur? … Knee Injuries: Medical History
Musculoskeletal system and connective tissue (M00-M99). Arthritis (inflammation of a joint), unspecified. Gonarthrosis (knee joint arthrosis) Hypertrophic (enlarged) Hoffa fat body (corpus adiposum infrapatellare) – this is located in the knee joint between condyle tibiae (tibial plateau), ligamentum patellae (patellar ligament) and the lower edge of the patella (kneecap). Meniscus cyst – encapsulated cavity in … Knee Injuries: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be contributed to by knee injuries: Cardiovascular system (I00-I99). Vascular damage to the affected region, unspecified. Musculoskeletal system and connective tissue (M00-M99). Ligament damage, unspecified Cartilage damage, unspecified Meniscus damage, unspecified Posttraumatic osteoarthritis Psyche – nervous system (F00-F99; G00-G99) Nerve damage to the affected … Knee Injuries: Consequential Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Examination of the knee joint (side to side) – including blood flow, motor function, sensitivity; meniscus tests, drawer tests, etc.[leading symptoms: pain, instability][other possible symptoms: joint effusion, joint swelling, deformity]. Inspection … Knee Injuries: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Inflammatory parameters – CRP (C-reactive preotein) – for suspected arthritis.
Therapy target Reduction of pain Therapy recommendations Analgesia (pain relief) during diagnosis until definitive therapy according to WHO staging scheme: Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. Tetanus prophylaxis – for injuries. See also under “Surgical therapy” and “Other therapy”.
To prevent knee injuries, attention must be paid to reducing individual risk factors. Behavioral risk factors Physical activity Sports that put a strain on the knees, such as soccer, handball, basketball, field hockey, or skiing Ski bindings set too hard! Knee injuries are twice as common in women as in men; experts call for the … Knee Injuries: Prevention
The following symptoms and complaints may indicate knee injuries: Leading symptoms Pain Instability Other possible symptoms Joint effusion Joint swelling Deformity Note: A rapidly bulging knee usually presents as an acute injury with hemorrhage. Meniscus injuries Meniscal contusion Local pressure pain No joint effusion Meniscus tear without stretch/bend inhibition. Local pressure pain Positive meniscus signs … Knee Injuries: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Meniscal Injuries Meniscal contusion is usually due to mild knee rotation. Acute meniscal tear with or without extension/flexion inhibition may be due to torsional trauma (knee twisting). Degenerative change of the meniscus is often present. Ligament injuries Knee joint injuries involving collateral/cruciate ligaments are usually due to trauma. Collateral ligament strain … Knee Injuries: Causes
General measures For meniscus, ligament, and cartilage injuries, follow the PECH rule: “P” break: stop playing sports, rest, immobilization. “E” ice/cooling: immediate application of cold, this is crucial for the healing process: it prevents the expansion of tissue damage; cold also has a pain-relieving effectNotes on implementation: repeat every 2 to 3 hours; do not … Knee Injuries: Therapy
