History & exam
Key factors
- presence of risk factors
- injury due to excessive or repetitive valgus loading of MCL
- medial knee pain
- joint effusion
- tenderness
- laxity on valgus stress testing
Other diagnostic factors
- audible pop or tearing sensation at time of injury
- difficulty walking
- instability symptoms of knee
- mechanical knee symptoms
- knee deformity
- ecchymosis
- positive anterior drawer test
- positive posterior drawer test
- positive Lachman's test
- positive pivot shift test
- joint line tenderness
- chronic pain
History & exam details
Diagnostic tests
1st tests to order
- plain x-rays of knee
- stress x-rays of knee (adolescent patients)
Tests to consider
- MRI of knee
Emerging tests
- diagnostic ultrasound
Diagnostic tests details
Treatment details
Acute
isolated grade I injury
- rest, ice, compression, elevation (RICE) + physiotherapy
- protective ambulation
- non-steroidal anti-inflammatory drugs (NSAIDs)
isolated grade II injury
- rest, ice, compression, elevation (RICE) + physiotherapy + protective ambulation
- non-steroidal anti-inflammatory drugs (NSAIDs)
isolated grade III injury
- rest, ice, compression, elevation (RICE) + physiotherapy + protective ambulation
- non-steroidal anti-inflammatory drugs (NSAIDs)
- MCL reconstruction or repair
MCL + anterior cruciate ligament (ACL) combined injury
- rest, ice, compression, elevation (RICE) + physiotherapy + protective ambulation
- non-steroidal anti-inflammatory drugs (NSAIDs)
- ACL reconstruction or repair
- MCL reconstruction or repair
MCL + non-anterior cruciate ligament (ACL) combined injury
- rest, ice, compression, elevation (RICE) + physiotherapy + protective ambulation
- non-steroidal anti-inflammatory drugs (NSAIDs)
- surgical repair of MCL + non-ACL ligament
Ongoing
persistent high-grade valgus laxity after ≥3 months
- ligament reconstruction or repair
- physiotherapy
- non-steroidal anti-inflammatory drugs (NSAIDs)
Treatment details
:آخر تحديث أبر 26, 2013
