A 17-year-old male complains of severe right knee pain. He was playing football when he heard a "pop" at the moment of being tackled and his knee "gave away" from under him
On physical examination, there is right knee swelling and decreased range of motion. There is a positive anterior drawer sign. These findings indicate:
A. Knee ligament injury
B. Osgood-Schlatter disease
C. Prepatellar bursitis
D. Chondromalacia patella
ANS: A
The anterior, medial, and lateral knee ligaments are vulnerable to injury in athletic activities. The mechanism through which the anterior cruciate ligament (ACL) is typically injured involves deceleration combined with sudden turning or pivoting. The medial collateral ligament (MCL) is most prone to injury through motions that place valgus stress on the knee. Compared with ACL and MCL injury, damage to the lateral collateral ligament (LCL) is much rarer but typically occurs when sudden varus stress is placed on the knee. The patient often relates history of an acute trauma followed by the onset of pain, swelling, and limited mobility. Often patients recall hearing or feeling a "pop" at the moment of injury and/or "give-away" sense. ACL injury is identified through a positive drawer (Fig. 14.9) and/or Lachman's test (Fig. 14.10). Laxity of the LCL is assessed by placing varus stress on the knee with the leg both extended and flexed.
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