REIDER PART 2 48
208 Chapter 6_Knce
208 Chapter 6_Knce
Figurę 6-12. Latcral collateral ligament scen with the knce in the figure-four position (arrows). (From Reider B: Sports Medicine: The School-Age Athlete. Philadelphia, WB Saunders, 1996, p 325.)
postcrior aspcct and inserting around the distal LCL. It is also visible in the flexed knee of many individuals.
Iliotibial Tract. Proceeding anteriorly from the biceps tendon, one encounters a smali depression and then another prominent longitudinal band, the iliotibial tract. The iliotibial tract is a thickening of the fascia lata, or the deep investing fascia of the thigh, which runs from the pclvis to the proximal tibia. Because it inserts both prox-imal and distal to the lateral joint linę, it contributes to the stability of the lateral sidc of the knee. Its most visible point of insertion is the tubcrcle of Gerdy on the proxi-mal tibia. This prominent tubercle is located anterior to the fibular head and may sometimes be mistaken for it.
Lateral Joint Linę. The lateral joint linę is less visible than the medial joint linę because much of it is covered by the iliotibial tract. In the presence of a chronic lateral mettiscus tear, a localized band of synovitis may occur along the lateral joint linę and create a characteristic bulge (Fig. 6-13). A lateral mettiscus cyst creates a rounder, firmer prominence at the midlateral joint linę that can vary from a few millimeters to marble-sizcd (Fig. 6-14). Lateral compartment degenerative arthritis can produce a ridge of visible osteophytes at the lateral joint linę.
POSTERIOR ASPECT
Semimembranosus, Semitendinosus, and Biceps Femoris. The posterior aspcct of the knee can be inspected with the patient standing, although it is usually morę com-fortable and convenient for both the examiner and the patient if it is done with the patient lying in the prone position. The focal point of the posterior knee is the popliteal fossa, a gap between the inferior hamstring and the superior calf muscles that is roughly diamond-shaped (Fig. 6-15). The superior limbs of this diamond are formed by the semimembranosus and semitendinosus muscles medi-ally and the biceps femoris laterally as they separate and course distally to their insertions below the knee joint. Asking the prone patient to flex the knee enough to raise
Figurę 6-13. Localized swelling associated with lateral meniscus tear (arrow).
Figurę 6-14. Very large lateral meniscus cyst.
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