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Patient case: Anterior Cruciate Ligament (ACL) Injury

Discussion

A 27-year-old woman presents to the clinic after injuring her right knee during a soccer game. She reports that while attempting to change direction quickly, she felt a "pop" in her knee, followed by immediate pain and swelling. She was unable to continue playing and had difficulty bearing weight on the affected leg. Over the next few hours, the swelling worsened, and she experienced instability in the knee when walking.

On physical examination, the right knee is swollen with decreased range of motion. There is tenderness around the joint, and the Lachman test is positive, indicating instability of the anterior cruciate ligament. An MRI is recommended to confirm the diagnosis of an ACL tear.

The patient is counselled on treatment options, including surgical reconstruction and rehabilitation versus conservative management with physical therapy, depending on her activity level and personal goals. Given her active lifestyle and desire to return to sports, she opts for surgical repair followed by a structured rehabilitation program.

Questions
1. What was the initial symptom the patient experienced at the time of injury?

a). Gradual pain after running

b). Feeling a "pop" in the knee

c). Numbness in the leg

d). Sharp pain in the ankle

 

2. What physical examination test was positive, suggesting an ACL injury?

a). Thompson test

b). Lachman test

c). Tinel’s sign

d). McMurray’s test

3. What imaging study is recommended to confirm the diagnosis of an ACL tear?

a). X-ray

b). CT scan

c). MRI

d). Ultrasound

4. What treatment option did the patient choose for her ACL injury?

a). Conservative management with physical therapy

b). Corticosteroid injections

c). Surgical repair with rehabilitation

d). Complete immobilization for 6 months

Reveal answers

Answers

  1. b). Feeling a "pop" in the knee
  2. b). Lachman test
  3. c). MRI
  4. c). Surgical repair with rehabilitation

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