Torn ACL (cont.)
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Torn ACL Diagnosis
The diagnosis of any knee injury begins with the history of how the injury occurred. Initially, the knee can be painful, swollen, and difficult to examine. The health-care professional may be able to detect the knee filled with fluid (effusion), but the pain and swelling may hinder the ability to assess whether any of the ligaments are damaged. If the swelling has decreased, the stability of the knee can be assessed by physical examination. There may be tenderness along the knee joint. The quadriceps muscle may be weak. There are maneuvers to test the stability of the ACL. These include the anterior drawer test, the Lachman's test, and the pivot shift test. Each is used to determine whether the connection between the femur and tibia is loose due to a torn ACL.
The physical exam also may be helpful in assessing other structures within the knee that may also be damaged. These include stressing the collateral ligaments and assessing the menisci or cartilage.
Plain X-rays may detect broken bones associated with an ACL tear. Magnetic resonance imaging (MRI) is done to evaluate the anatomy of the knee, and it can detect injuries to the ligaments, meniscus, and bone. While it is used to visualize the anatomy, it is not a replacement for the history and physical exam. Not all patients with knee injuries require an MRI.
Medically Reviewed by a Doctor on 6/4/2014
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