🦵 Chapter 718 · The Knee

Nelson Textbook of Pediatrics 22nd Edition | Discoid lateral meniscus (snapping knee, Watanabe classification, saucerization), popliteal (Baker) cyst, osteochondritis dissecans (OCD) of femoral condyle, Osgood-Schlatter disease (tibial tubercle apophysitis), Sinding-Larsen-Johansson (inferior patellar pole), patellofemoral pain syndrome (anterior knee pain), patellofemoral instability (MPFL reconstruction), ACL rupture (Lachman, pivot shift, physeal-sparing reconstruction).

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📋 30 Clinical Scenarios — Knee Disorders (Nelson Ch 718)

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Knee Pain & Pathology

Select a presentation to review diagnostic clues and management per Nelson Ch 718.

📋 Stepwise Management of Common Knee Disorders

🔑 Key Principles — Nelson Chapter 718
• Discoid meniscus: Snapping knee, MRI shows continuity >20% tibial coverage. Saucerization + repair if torn.
• OCD: Stable (intact cartilage) → rest + limited WB. Unstable → drilling/fixation. Skeletally immature better prognosis.
• Osgood-Schlatter: Tibial tubercle pain, activity modification, quadriceps/hamstring stretching, patellar strap.
• Patellofemoral pain: PFPS = anterior knee pain, no instability. PT (VMO, hip/core strengthening).
• Patellar instability: Acute dislocation → immobilization + PT. Recurrent → MPFL reconstruction.
• ACL tear: Lachman + pivot shift. MRI confirms. Reconstruction (physeal-sparing if open physes).
• Baker cyst: Popliteal mass, transilluminates. Usually resolves spontaneously. If persistent, MRI to rule out intra-articular pathology.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: The Knee (Nelson 718)