MSK Knee Practice Questions

a 40 year old female presents to the clinic with complaints of R Ant Knee Pain but no pain with squatting. Which of the following diagnoses can MOST LIKELY be ruled out?

a. Patellofemoral Pain Syndrome

b. Meniscus Pathology

c. Patellofemoral Knee OA

d. Pes Anserine Bursitis

Patellofemoral Pain Syndrome

At 6 months post-op ACL reconstruction, what score on the ACL Return to Sports after Injury Questionnaire is needed to predict successful return to sport?

a. 45%

b. 65%

c. 61%

d. 55%

65%

in a patient presenting with IT band syndrome, which structure is likely to be most tender to palpation?

a. lateral femoral condyle

b. lateral joint line

c. lateral tibial condyle

d. fibular head

lateral femoral condyle

which special test is the most diagnostic for ruling IN a meniscus tear?

a. Thessaly

b. Joint Line Tenderness

c. eccentric step down

d. McMurray

McMurray

a patient reports a pain level of 8 on the VAS after a knee injury and after initial evaluation. which of the following interventions is most appropriate to administer?

a. seated long-arc quads

b. grade I/II joint mobs

c. single leg stance with bilateral UE support

d. prone knee bends

grade I/II joint mobs

a 70 YO M patient scored a 45 on the KOOS pre-treatment. After 8 weeks of PT he scores a 60. Based on the MCID for the KOOS, by how many points has the patient achieved a clinically significant improvement?

a. 3

b. 4

c. 5

d. 6

5

a returning patient presents after a month absence with worsening, severe, sharp, constant pain that is worse at night. They appear to have lost a significant amount of weight. their temp is 101.2. What should be your next course of action?

a. lay them in supine and check their BP

b. refer for imaging

c. refer to a physician immediately

d. apply ice and compression to the knee

refer to a physician immediately

during which part of the gait cycle is the knee in its most flexed position?

a. terminal stance

b. loading response

c. midswing

d. initial swing

initial swing

which of the following exercise strategies is most appropriate to manage pain and improve function in patients with PFPS?

a. isolated hip adductor strengthening

b. open-chain knee extension exercises at end ranges

c. closed-chain exercises focusing on hip and knee alignment

d. heavy resistance training targeting knee flexion

closed-chain exercises focusing on hip and knee alignment

which of the following interventions is recommended in the early phase of rehab for a patient with an ACL sprain?

a. high-intensity plyometric exercises

b. open-chain knee extension exercises

c. neuromuscular electrical stimulation

d. deep squats

neuromuscular electrical stimulation

a 22 YO soccer player is 8 weeks post-ACLR and has been cleared to begin dynamic stability training. Which of the following exercises would be most effective for improving dynamic stability at this stage of recovery?

a. quad sets performed with a resistance band

b. single leg balance with reaching in multiple directions

c. seated hamstring curls using a resistance machine

d. passive ROM exercise for knee flexion

single leg balance with reaching in multiple directions

a 28-year old runner with PFPS reports pain when ascending stairs and squatting. Which intervention is MOST appropriate to address the underlying impairments?

a. open-chain terminal knee extension exercises

b. hip abduction and external rotation strengthening

c. isolated hamstring curls with resistance

d. patellar mobilization

hip abduction and external rotation strengthening

a soccer player presents with a grade II MCL sprain. Which intervention is MOST appropriate during the subacute phase of healing?

a. application of cryotherapy and immobilization

b. use of a hinged brace with progressive weight-bearing exercises

c. end-range isokinetic training for the HS

d. plyometric training to enhance power output

use of a hinged brace with progressive weight-bearing exercises

a patient with a Grade I PCL sprain has difficulty with stair climbing and deceleration activities. Which intervention is MOST appropriate to restore functional strength ?

a. progressive resistance training for the quads

b. closed-chain HS strengthening exercises

c. plyometric box jumps for power development

d. gentle knee flexion stretches to improve ROM

progressive resistance training for the quads

patient education is a critical component of managing knee OA. all of the following statements are appropriate for knee OA patient education EXCEPT:

a. "I understand you are fearful to hurt the knee with exercise, but soreness is a normal response to starting new physical activity"

b. "inactivity can worsen your symptoms and i encourage you to continue physical activity as tolerated?

c. "your x-rays are invaluable and tell us exactly how bad your arthritis is"

d. "there are strategies you can use to manage your symptoms and maintain your quality of life"

"your x-rays are invaluable and tell us exactly how bad your arthritis is"

a 45-year-old patient presents with a medial meniscus tear. which of the following factors is most likely to influence the decision to perform a menisectomy instead of a meniscal repair.

a. the tear is located in the vascular zone

b. the patient is older, and the tear is in the avascular zone

c. the patient is experiencing minimal swelling or locking

d. the goal of treatment is to preserve as much meniscal tissue as possible

the patient is older, and the tear is in the avascular zone

A PT is developing a POC for a patient 4 weeks post TKA. According to standard post-operative guidelines, which progression is MOST appropriate for this stage?

a. achieving 0-90 degrees of ROM

b. transitioning from a walker to full WB w/o an AD

c. initiating resisted exercises for quadriceps and hamstrings

d. performing 0-120 degrees of knee flexion

achieving 0-120 degrees of knee flexion

A patient recovering from TKA reports persistent pain and swelling. Which pharmacological management option is MOST strongly recommended based on current evidence?

a. Oral NSAIDS for pain and inflammation management

b. long-term use of intra-articular glucocorticoid injection

c. short term use of intra-articular glucocorticoid injections

d. topical NSAIDS combined with systemic corticosteroids

Oral NSAIDS for pain and inflammation management

you are evaluating a 65 YO F for the first time. They have knee pain that has worsened over the last year, with morning stiffness and rising from a chair. Your initial suspicion is knee OA. which outcome measure is MOST appropriate to administer?

a. VAS

b. KOOS

c. IKDC-2000

d. ACL-RSI

KOOS

a 35 YO construction worker presents with a suspected meniscal tear. To guide the initial intervention plan, which activity-based modification is MOST appropriate?

a. partial WB with crutches and quad isometrics

b. closed-chain squats with a deep knee bend

c. high-impact running drills to test tolerance

d. stretching of the knee extensors to full end-range

partial WB with crutches and quad isometrics

a 25 year old patient is performing open-chain knee extension exercises after an ACLR. Which of the following best describes the arthrokinematics of the tibiofemoral joint during this motion?

a. femur glides anterior on tibia

b. tibia glides posteriorly on femur

c. tibia glides anteriorly on femur

d. femur glides posterior on tibia

tibia glides anteriorly on femur

a 40 YO patient is recovering from knee surgery and presents with stiffness and limited knee flexion ROM. the therapist decides to perform joint mobs to improve flexion. based on the arthrokinematics of the tibiofemoral joint, which direction should the therapist apply the mob?

a. anterior glide of the tibia

b. posterior glide of the tibia

c. superior glide of the patella

d. posterior glide of the femur

posterior glide of the tibia

a 30 YO recreational soccer player was involved in a collision during a game. they report falling directly onto a bent knee with their foot plantarflexed. they now have posterior knee pain and difficulty walking downhill. Upon examination, there is a positive posterior drawer test. based on the MOI, what is the likely diagnosis?

a. ACL tear

b. MCL sprain

c. Patellar tendon Rupture

d. PCL injury

PCL injury

a 22 YO basketball player lands awkwardly from a jump and immediately feels a "pop" in their knee. they present with significant swelling and instability with cutting movements. the therapist wants to perform special tests to assess for an ACL tear. Which of the following tests is the most sensitive for ruling out an ACL tear if negative?

a. Lachman

b. Valgus Stress Test

c. Anterior Drawer Test

d. Pivot Shift Test

Lachman

a 28 YO soccer player presents to the clinic two days after sustaining a knee injury. the therapist perform the brush test to assess for effusion. After stroking upward on the medial side of the patella and then downward on the lateral side, a small wave of fluid returns to the medial aspect of the knee. how would this effusion be graded?

a. 0

b. Trace

c. 1+

d. 2+

trace

a 55 YO patient presents to the ED after falling and landing directly on their knee. the clinician considers the ottawa knee rules to determine if imaging is necessary. Which of the following is NOT a criterion of the Ottawa Knee Rules?

a. age >55

b. TTP at the fibular head

c. inability to WB immediately and in the ER (4 steps total)

d. TTP over the MCL

TTP over the MCL

a 60 YO patient is 10 days post-op from a TKA and presents with increasing calf pain, swelling, and warmth. upon examination, the therapist notes tenderness along the posterior calf and a positive Homan's sign. the patient denies recent trauma to the area. what is the most appropriate next step?

a. perform aggressive STM to reduce swelling

b. continue therapy but monitor symptoms over the next few sessions

c. immediately refer the patient to a physician or ED for further evaluation

d. instruct the patient to perform ankle pumps and elevate the leg to improve circulation

immediately refer the patient to a physician or ED for further evaluation

a 65 YO patient with a hx of Knee OA presents with complaints of pain, stiffness, and difficulty performing ADLs. The PT is looking for an outcoe measure that specifically addresses symptoms and function related to knee OA. which of the following outcome measures would be most appropriate for this patient

a. WOMAC

b. FAAM

c. Tegner Activity Level Scale

d. KOOS

KOOS

which of the following ACL-RSI scores at 6 months post-ACLR is considered most likely to indicate a favorable prognosis for returning to sport?

a. < 42

b. <60

c. >62

d. >80

>62

which of the following is NOT considered first-line treatment for knee OA?

a. supervised exercise

b. opioid meds

c. Weight Loss

d. Patient education

opioid meds

A study comparing the glute med muscle activity during 12 different exercises found significant differences in muscle activation. which of the following exercises produces the greatest activation of the glute med?

a. side lying hip abduction

b. clamshells

c. lateral band walk

d. transverse hop

side lying hip abduction

A study comparing glute max muscle activity during 12 exercises found significant differences in activation. which of the following exercises produces the greatest activation of the glute max?

a. Hip Clams with 30* of hip flexion

b. forward hop

c. single limb squat

d. lateral band walk

single limb squat

which of the following is TRUE regarding ACL return-to-sport guidelines?

a. athletes can return to sport as early as 6 months post-op if they feel ready

b. running can begin once 60% quad strength is achieved

c. sport-related activity should begin immediately after surgery to promote faster recovery

d. restoring normal ROM should be achieved by weeks 6-8

restoring normal ROM should be achieved by weeks 6-8

a 32 YO basketball player presents to the clinic with medial knee pain and reports a popping sensation after landing awkwardly from a jump. you suspect a medial meniscus tear and decide to perform the McMurray Test. Which of the following techniques would BEST assess the integrity of the medial meniscus?

a. flex the knee while applying tibial IR and varus stress

b. flex the knee while applying tibial ER and valgus stress

c. extend the knee while applying tibial IR and valgus stress

d. flex the knee while applying tibial ER and varus stress

flex the knee while applying tibial ER and valgus stress

a 22 YO soccer player is eager to return to play following ACLR. Based on research regarding return to sports criteria, which of the following strategies would BEST reduce their risk of re-injury?

a. delaying return to sport until at least 9 months post-op, as each additional month of delay between 6 and 9 months reduce re-injury risk by 58%

b. returning to play as soon as they regain full knee ROM and strength symmetry at 6 months

c. returning at 6 months, as research shows no increased risk of re-injury beyond this point

d.avoiding sport altogether, as athletes post-ACLR have a 100% risk of reinjury within 24 months

delaying return to sport until at least 9 months post-op, as each additional month of delay between 6 and 9 months reduce re-injury risk by 58%

which of the following groups would benefit the MOST from ACL injury prevention exercises?

a. Male athletes over 25 years old who participate in low-contact sports

b. female soccer players and handball players aged 15-17

c. athletes of all ages, regardless of sport or injury risk

d. only professional athletes with a history of ACL injury

female soccer players and handball players aged 15-17

which of the following is a key component of an effective ACL injury prevention program?

a. skipping strength training and only performing during the competitive season

b. completing the program once a week for 10 minutes per session

c. focusing only on plyometric training with no strength or proximal control exercise

d. performing the program for at least 14 months, multiple times per week, both preseason and in-season

performing the program for at least 14 months, multiple times per week, both preseason and in-season

a 62 YO patient is preparing for a TKA due to severe OA. which of the following factors is most likely to contribute to a poorer post-surgical prognosis?

a. pre-op participation in PT

b. presence of multiple comorbidities

c. higher pre-op quad strength

d. good baseline physical function

presence of multiple comorbidities

which of the following pharmalogic approaches has strong evidence to support its use in managing knee OA?

a. glucosamine

b. intra-articular hyaluronic acid

c. oral NSAIDs

d. stem cell injections

oral NSAIDs

You are treating a 25 YO runner for patellofemoral pain syndrome. Her typical training schedules consist of 2x 5mi runs, 1x hill runs, and 3x strength training. Which of the following would be the MOST appropriate modification to her training schedule:

a. no more running and do 5x heavy strength training

b. 3x 5mi runs and yoga

c. 4x 3mi runs with 2/10 pain and maintain strength training as tolerated

d. stop all activity for 4 weeks

4x 3mi runs with 2/10 pain and maintain strength training as tolerated

You are treating a 50 YO for ANT knee pain and notice a large effusion on their R knee. You want to monitor the swelling over the course of treatment so you choose to perform the Brush Test. As you perform the test you see effusion spontaneously return to the medial side after the upstroke. What score would you grade this response?

a. 1+

b. 2+

c. 3+

d. 0

2+

You are monitoring an ACLR patient for return to sport. In addition to to no knee instability, which of the following criteria would determine a patient is 14x more likely to return to sport?

a. >88% on IKDC-2000 and >90% to CL limb on Single Limb Hop for Distance

b. >90% on KOOS and 70% Quad to HS strength

c. 130 on OREBRO and 85 on AKPS

d. >93% on IKDC-2000 and no effusion

>93% on IKDC-2000 and no effusion

A PT reviews the medical record of a 22 YO athlete rehabbing from ACLR. which piece of objective data would serve as a barrier to the patient returning to high-demand competitive athletics ?

a. 0-135* knee ROM

b. HS/Quad strength ratio of 50%

c. Quad strength of 90% of the CL limb

d. negative lateral pivot shift test

HS/Quad strength ratio of 50%

You have been treating a 55 YO M post-TKA for 4 weeks. Today this patient comes in looking unwell and quieter then prev sessions. When reviewing this patient's vitals you note the patient has a temperature of 100. You note when the patient rolls his pants up his knee looks swollen and there's some erythema. How should you proceed?

a. Perform STM to decrease swelling and monitor symptoms

b. Proceed as normal, just document changes in the daily note

c. Cancels today's session due to signs of elevated temperature/fever

d. Immediately refer to Physician/ED

Immediately refer to Physician/ED

You have been treating a 55 YO M post-TKA for 4 weeks. Today this patient comes in looking unwell and quieter then prev sessions. When reviewing this patient's vitals you note the patient has a temperature of 100. You note when the patient rolls his pants up his knee looks swollen and there's some erythema. What do you suspect this patient is experience?

a. Cellulitis

b. Septic Arthritis

c. Compartment Syndrome

d. Bee Sting

Cellulitis

a 19 YO F volleyball player comes into your clinic for L Ant Knee Pain. She reports that after the start of the seasoning she noticed pain whenever jumping or running during practice. You suspect Patellar Tendinopathy, which of the following exam findings would MOST likely support that diagnosis?

a. Hypermobility of the patella

b. Pain with Step Down

c. Tight Hamstrings

d. Quad Dominant Jump

Quad Dominant Jump

you are treating 58 YO M for Knee Pain. Patient PMHx includes knee OA and a BMI of 33. As you are performing the examination you note the following symptoms: Tenderness along the medial joint line; valgus deformity during gait; TTP at the semitendinosus; stiffness at end range of motion; pain with resisted flexion. Which of the following do you MOST likely suspect?

a. Knee OA

b. Medial Meniscus Tear

c. Pes Anserine Bursitis

d. Septic Arthritis

Pes Anserine Bursitis

A 28 YO M reports to your clinic direct access after pain while training for a triathlon. He recently increased his training load and noticed during his runs that his knee pain increases when running (especially downhill) or when he rides his bike. Based on this patient history, you should have increased suspicion for which diagnosis?

a. PFPS

b. IT Band Syndrome

c. Patellar Tendinopathy

d. Knee OA

IT Band Syndrome

You have a patient report to your clinic 4 weeks post-op. This patient reports that their pain is increased while sitting and driving. They complain of difficulty while walking due to tripping over their own feet at times. During the clinical exam, you note there is decreased sensation at the lateral aspect of the knee. Which of the following do you MOST likely suspect?

a. L3 involvement

b. Lateral Meniscus Tear

c. Common Peroneal Neuropathy

d. IT Band Syndrome

Common Peroneal Neuropathy

Which of the following structural deformities will cause increased strain on the LCL?

a. Genu Varum

b. Genu Valgum

c. Genu Recurvatum

d. All of the Above

Genu Varum

You have been monitoring a patient post-TKA and you have been using the TUG as an outcome measure to assess their balance. When you first performed the TUG on this patient it took them 17.5 seconds. At your most recent progress note, you perform the TUG again and this time the patient takes 14 seconds. Which of the following is the most accurate assessment of these results?

a. This is NOT a meaningful change, but the patient is NOT a fall risk

b. This is NOT a meaningful change and the patient is a fall risk

c. This is a meaningful change, and the patient is NOT a fall risk

d. This is a meaningful change, but the patient is a fall risk

This is a meaningful change, but the patient is a fall risk

Which of the following is TRUE about the Varus Stress test

a. It has a +LR of 2.3

b. Better for ruling out

c. Used for MCL pathology

d. None of the above

None of the above

You are treating a patient for Knee OA, which of the following would be the MOST appropriate intervention for this patient?

a. Wedged Insoles

b. Yoga/Tai Chi

c. GLA:D Program

d. Knakontroll

GLA:D Program

Which of the following would be the best ACL injury prevention program?

a. 14 month program that meets 3x/wk with a focus on proximal control, strength, and plyometrics

b. 3 month program that meets 2x/wk with a focus on flexibility, strength, and running

c. 12 month program that meets 2x/wk with a focus on plyometrics and core control

d. 8 month program that meets 3x/wk with a focus on static flexibility, strength, and running

14 month program that meets 3x/wk with a focus on proximal control, strength, and plyometrics

Which of the following would NOT be considered a barrier to return to sport post-ACLR?

a. Fear of Reinjury

b. Low Internal health locus of control

c. score of 58 on ACL-RSI at 6 months

d. High pre-op quad strength

High pre-op quad strength

Which of the following objective measurements is the MOST important indicator for return to sport?

a. quad strength

b. HS strength

c. ACL-RSI score at 6 months

d. Star-Excursion Test Score

quad strength

You are treating a post-TKA patient. As you are treating them, you are always looking out for which of the red flag pathologies based on their post-op status?

a. AVN

b. RA

c. DVT

d. Peripheral Arterial Occlusive Disease

DVT

You are treating a 60 YO F 4 weeks post-TKA. As you review her medical record you note the following things: BMI of 30, completed 10 prehab sessions; in home health achieved 0-90 degrees ROM; walking with a cane. Of those which would be associated with a worse prognosis?

a. BMI of 30

b. completed 10 prehab sessions

c. achieved 0-90 degrees of ROM

d. Walking with a cane

BMI of 30

a PT is developing a POC for a patient. Your clinical exam shows the following results: Hypermobile Patella, Positive Pain with Squatting Test, excessive dynamic knee valgus. Which of the following would be the MOST likely diagnosis and a 1st line treatment option?

a. Knee OA; Weight Loss

b. ACL tear; Intra-articular glucosteroid injection

c. Compartment Syndrome, ED referral

d. PFPS; Patellar Taping

PFPS; Patellar Taping

For which of the following diagnoses is there STRONG evidence for the short-term use of prefabricated foot orthoses?

a. OA

b. PFPS

c. ACL

d. Meniscal tear

PFPS

Which of the following diagnoses would benefit the MOST from gait retraining to a forefoot strike?

a. Meniscal Tear

b. HS Tear

c. PFPS

d. IT Band Syndrome

PFPS

You are treating a 35 YO construction worker for a meniscal tear. Which of the following from the patient history would most likely indicate the need for Blue flag screening?

a. "I've tried PT before and it didn't help my knee at all"

b. "I'm so tired all of the time, and I have no energy that I don't even go out with my friends anymore"

c. "IDK why my doctor referred me for PT, I already use a heating pad and tylenol."

d. "how quickly will this take? I really need to get back to work."

"how quickly will this take? I really need to get back to work."

if a patient is trying to avoid knee extension, which of the following is the MOST likely deviation you will see during gait?

a. over flexing the hip

b. trendelenburg

c. excessive hip adduction

d. late heel elevation

over flexing the hip