Review Question - QID 109014

This patient is presenting with pain in his knee after experiencing trauma. His symptoms of pain, erythema, a locking sensation upon walking, and clicking of the joint suggest a diagnosis of a medial meniscal tear.

A medial meniscal tear typically occurs with twisting trauma to a knee. The knee will often be bruised, as well as have erythema, edema, and tenderness upon palpation. Typically, these patient’s will describe a “catching” or “locking” sensation in their knee when they are walking and may also complain of a feeling of instability. Another specific finding on physical exam is clicking of the knee upon passive range of motion. Most cases resolve spontaneously, and rest and NSAIDs are all that are needed. Refractory cases can be treated with a menisectomy.

Incorrect Answers:
Answer 2: Lateral meniscus damage would present similarly except the pain and tenderness would be experienced laterally, as compared to in this patient where his symptoms are medial.

Answer 3: Medial collateral ligament tears can present similarly with pain, erythema, and edema of the medial knee. However, physical exam findings will reveal a laxity to valgus stress rather than the clicking palpated upon passive range of motion of the knee.

Answer 4: Lateral collateral ligament tears can present with pain, erythema, and edema of the lateral knee. However, physical exam findings will reveal a laxity to varus stress rather than the clicking palpated upon passive range of motion of the knee.

Answer 5: Anterior cruciate ligament tears will present with pain, erythema, and edema of the knee. Patients will complain of a profound instability in the knee, and on physical exam there will be anterior displacement of the tibia relative to the femur during the anterior drawer test.

Bullet Summary:
Patients with meniscal tears may complain of knee instability and a catching or locking sensation upon walking.