nmbe#17 - clinical

[ArchivalUser]

17. A 21-year-old woman who is a varsity basketball player comes to the student health center because of left knee pain for the past month. She says the pain has progressively worsened and has not been relieved with ibuprofen. The pain occurs when she descends stairs or is in class for long periods. She says, "My knee pops a lot." Physical examination today shows knee crepitus, and weakness and atrophy of the vastus medialis muscle. Which of the following is the most appropriate treatment at this time?

A

) Anterior cruciate ligament reconstruction

B

) Arthroscopic meniscectomy

C

) Immobilization of the knee

D

) Nonweight-bearing on crutches for 2 weeks

E

) Quadriceps-strengthening exercises


i think BB is the correct ans ( medial meniscal tear ).......squatting and twisting injury in basketball player . locking and catching and popping of knee ....tenderness over medial joint . definitive surgical debridement and repir is the treatment .......

[ArchivalUser]

Hi,
No this is typical case of a patellofemoral pain syndrome (PFPS).

Key points:

1)Typically knee pain worsens with squatting, running, prolonged sitting, or when ascending or descending steps .

2)Patients may describe an audible "popping" or "creaking" often after standing following prolonged sitting, or when ascending or descending stairs.

3 ) on Examination
-vastus medialis atrophy
-quadriceps strength is limited, look for hip abductor and external rotator weakness, note strength discrepancies between affected and unaffected lower extremities

Treatment:

•Activity modification – Patients need to avoid activities that cause pain during rehabilitation.
anf applying ice to the anterior knee

Note: There is no evidence to support the long term use of nonsteroidal antiinflammatory drugs (NSAIDs) for the treatment of PFPS

So answer will be D
Take care

[ArchivalUser]

agree. thanks.

[ArchivalUser]

patellofemoral pain syndrome

E

[ArchivalUser]

EEEE