Stress radiographs of the knee are used for many reasons during workup or recovery for a potential ligamentous injury or osteoarthritis.
Stress radiographs of the knee are used for many reasons during workup or recovery for a potential ligamentous injury or osteoarthritis. The most common stress radiographs include varus stress which stresses the lateral compartment ligaments, valgus stress for the medial compartment ligaments or posterior stress for the meniscofemoral or posterior knee ligaments. Most of the time a manual stress is used, or a stress provided by a healthcare professional and many times this is the ordering physician.
There are issues performing stress radiographs if these are not a common part of the practice and setting the patient up can be difficult. There have been attempts recently to have patient directed stresses using certain props. The most commonly injured area of the knee is the MCL, or medial collateral knee ligament, and stabilizers in the medial knee.
Physical examination is one of the first steps in diagnosis of knee injuries. This will usually include a valgus stress to the medial knee ligaments at both full extension and 30 degrees of knee flexion. Many providers will grade MCL injuries depending on this.
The grading of these injuries depends both on relaxation of the patient and clinician’s ability to detect an endpoint. Many also describe laxity at full extension to be indicative of a and MCL and cruciate ligament injury. Clinician experience, patient pain tolerance or guarding, and concurrent ligamentous injuries may skew physical examination interpretation, detracting in certain situations from its clinical use.
This provides a more objective method of measuring medial knee injuries. Stress radiographs can be used to judge the degree of instability with a measurement of medial compartment gapping. The medial collateral ligament is most commonly affected, but the medial knee does have additional stabilizers.
If you are experiencing symptoms that may be related to stress radiographs of the knee, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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