Clinical presentation

clinical presentation

History is an important factor in diagnosing the injury early.

• typically a history of traumatic injury is present and is most commonly due to valgus stress on the knee joint.
• patient may complain of a tearing sensation and if an auditory 'pop' is present, suspect high energy injuries and involvement of additional structures (1)
• in one study 76% of patients with complete MCL tears wlaked into the doctors office without any support (2)

Some patients may present with an effusion suggesting a severe injury or concomitant damage to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) or meniscus

• patients should be inquired about time and onset of swelling
• an acute effusion (within two hours of injury) - indicates hemarthrosis
• swelling within 12-24 hours after injury - indicates a synovial effusion (2)
• in multiligament knee injuries, capsular disruption may result in swelling and eccymosis down the leg (with minimal swelling of the knee) (1)

Incomplete tears tend to hurt more than complete tears (2)

Reference:

• (1) Duffy PS, Miyamoto RG. Management of medial collateral ligament injuries in the knee: an update and review. Phys Sportsmed. 2010;38(2):48-54
• (2) Phisitkul P et al. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006;26:77-90