11-06-2006, 05:13 AM
A 65-year-old male jumps off of a bus to catch a train. He immediately feels very severe pain in the front of the knee and hears a snap. He falls to the ground and is unable to rise. The emergency physician determines that the patient is a diabetic whose diabetes is controlled by oral hypoglycemics. He has no allergies and is not on any other medications. He exercises occasionally, and he is overweight. His vital signs are as follows: pulse, 86/min; respirations, 18/min; blood pressure, 150/97 mm Hg. His temperature is normal. The patient complains of pain in the right knee. Clinical examination reveals swelling and tenderness in the anterior aspect of the knee, and a sulcus is palpable proximal to the superior pole of the patella; no fragments can be moved. The patient is unable to extend the knee. Hemarthrosis is absent. Which of the following is the most likely diagnosis?
A: Tear of the posterior cruciate ligament
B: Tear of the anterior cruciate ligament
C: Transverse fracture of the patella
D: Tear of the quadriceps expansion
E: Avulsion of the quadriceps tendon from the tibial tuberosity
A: Tear of the posterior cruciate ligament
B: Tear of the anterior cruciate ligament
C: Transverse fracture of the patella
D: Tear of the quadriceps expansion
E: Avulsion of the quadriceps tendon from the tibial tuberosity