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Difficulty: EasyOrthopedic Surgery

Match the following common musculoskeletal injuries with their classic, diagnostic physical examination findings.

  • Anterior cruciate ligament tearIncreased anterior translation of the tibia with the knee flexed at 20 to 30 degrees
  • Medial meniscus tearPain and a palpable click when extending the flexed knee with external rotation of the foot
  • Achilles tendon ruptureAbsence of plantar flexion upon squeezing the calf
  • Supraspinatus tendon tearWeakness and pain with shoulder abduction while the arm is internally rotated

Answer

Anterior cruciate ligament tear matches with increased anterior translation (Lachman test). Medial meniscus tear matches with pain/click on knee extension with external rotation (McMurray test). Achilles tendon rupture matches with absence of plantar flexion on calf squeeze (Thompson test). Supraspinatus tendon tear matches with weakness in internally rotated shoulder abduction (Empty Can test).
Each physical examination finding is the hallmark diagnostic test for its respective injury: the Lachman test for ACL tears, the McMurray test for meniscal tears, the Thompson test for Achilles ruptures, and the Empty Can test for supraspinatus tears.

Step-by-Step Solution

1
Identify the anatomical focus and mechanism of action for each physical exam finding.
Right 1 assesses the calf/ankle. Right 2 assesses the shoulder. Right 3 and 4 assess the knee.
Categorizing tests by joint helps narrow down the potential matching injuries.
2
Correlate the specific knee tests with their respective intra-articular structures.
Right 3 (Lachman test) evaluates anterior stability, correlating with the ACL. Right 4 (McMurray test) traps loose cartilage, correlating with the medial meniscus.
Differentiating knee exam findings is crucial since multiple injuries occur in this joint.
3
Link the remaining tests to the ankle and shoulder injuries.
Right 1 demonstrates a loss of continuity between the calf muscles and the heel, indicating an Achilles rupture. Right 2 isolates abduction, pointing to the supraspinatus.
These are pathognomonic functional deficits for these specific tendon injuries.

Key Concept

Diagnostic physical examination maneuvers for common orthopedic soft tissue injuries.
Estimated Time:1m 0s
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Orthopedic Surgery

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