Leg/Knee Case 11 History/Physical Exam

Patients may report a history of acute traumatic injury while playing sports or after involvement in a biking accident or motor vehicle collision. The mechanism of injury is most often hyperextension of the knee with valgus-external rotation as in ACL injuries. Patients will describe pain and difficulty bearing weight and walking.  

On exam, the knee will often be held in slight flexion with significant ballotable effusion. Range of motion may be limited by pain.  After pain control, if decreased passive and active range of motion persists, entrapment of meniscal injury or fracture fragment should be suspected.  Abnormal knee provocative testing of the knee ligaments and menisci confirm the frequently associated injuries but may be limited in the acute presentation by pain and swelling.