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Review Question - QID 109013

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QID 109013 (Type "109013" in App Search)
A 23-year-old male presents to his primary care physician after an injury during a rugby game. The patient states that he was tackled and ever since then has had pain in his knee. The patient has tried NSAIDs and ice to no avail. The patient has no past medical history and is currently taking a multivitamin, fish oil, and a whey protein supplement. On physical exam you note a knee that is heavily bruised. It is painful for the patient to bear weight on the knee, and passive motion of the knee elicits some pain. There is laxity at the knee to varus stress. The patient is wondering when he can return to athletics. Which of the following is the most likely diagnosis?

Medial collateral ligament tear

13%

9/70

Lateral collateral ligament tear

77%

54/70

Anterior cruciate ligament tear

3%

2/70

Posterior cruciate ligament tear

0%

0/70

Meniscal tear

6%

4/70

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This patient is presenting with trauma to his knee, and laxity to varus stress suggesting a diagnosis of a lateral collateral ligament (LCL) tear.

The lateral collateral ligament is commonly injured in athletic events with medial impact to a planted foot. Typically there will be pain and edema surrounding the knee, in particular the LCL. The diagnosis can typically be established with a thorough physical exam that reveals laxity of the knee to varus stress (pressing the leg medially). If physical exam is not revealing, the most accurate test for diagnosis is an MRI of the knee.

Incorrect Answers:
Answer 1: Medial collateral ligament (MCL) tear occurs due to lateral trauma to a planted leg and results in laxity to valgus stress.

Answer 3: Anterior cruciate ligament (ACL) tear typically presents with trauma to a knee, erythema, edema, and laxity to anterior stress (anterior drawer test).

Answer 4: Posterior cruciate ligament (PCL) tear presents presents with trauma to a knee, erythema, edema, and laxity to posterior stress (anterior drawer test).

Answer 5: Meniscal tear can present with swelling and pain, and a catching or locking sensation with motion of the knee. Patients will often state that their knee feels unstable.

Bullet Summary:
An lateral collateral ligament (LCL) tear occurs due to medial trauma to a planted leg and presents with pain, edema, and laxity to varus stress.

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