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Leg

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Introduction

Anatomy

The knee is the largest joint in the body.

It is very complex, hinge-like. It is subject to constant pounding and twisting

THe ligaments work together, along with the menisci and leg muscles, to stabilize joint and allow knee to generate and deliver large quantities of power required for activity.

Extension

Quadraceps, quad tendon, patella, tendon, tubercule

The menisci provide suspension

Knee Injuries are a serious problem

physical, emotional, and economic consequences

Common pathologies of the knee include:
Patello-femoral syndrome: misalignment in patello-femoral articulation with a dull aching over knee’s anterior surface and pain worse when going downstairs, squatting, or sitting up to a stand after watching a long hockey game! Quadriceps may be atrophic
Meniscal injury: look for a trauma, locking and clicking of knee, tenderness along joint line (tell tale sign!)
Ligamentous injury: look for a trauma, acute/severe pain, sudden effusion likely hemarthrosis if rapid onset. Also look for limited ROM (muscle spasm), bruising, instability.
O’Donoghue’s triad: ACL with MCL and medial meniscal injury

A single, very swollen, hot knee requires strong suspicion of septic arthritis. This presentation is almost always pathologic!
Swelling above the patella itself -> think prepatellar bursitis and not an effusion.