40 year old rock climbing injury. MRI Knee

Not a very common injury. Patient describes twisting injury “putting weight
on it while foot was caught in a hole on the side of a mountain”.

What do you think was the primary mechanism?

A. Internal rotation and valgus stress with axial loading.
B. External rotation of the femur against a fixed tibia with valgus stress.
C. Varus stress on the knee with a fixed foot.
D. Varus stress of the knee and internal rotation with a fixed foot.
E. Listening to rock music at excessive volume through earbuds while rock
climbing.
E. Either C or D is most likely.

I realize that seeing a “test” question causes anxiety in a large
percentage of physicians. You don’t have to reply, just think about the
mechanism as hopefully a fun exercise. 🙂

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