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Orthopaedics · Knee: J sign
Sample itemAs a patient with recurrent patellar instability actively extends the knee from a flexed position, the patella shifts laterally in a J-shaped path at terminal extension. What does this J sign indicate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Patellar maltracking, as in trochlear dysplasia or patella alta
A J sign is lateral displacement of the patella in terminal extension as it leaves the trochlear groove, and it indicates maltracking. It is associated with trochlear dysplasia, patella alta and a lateralised tibial tuberosity. It guides surgical planning such as tibial tubercle transfer.
Option by option
A. Anterior cruciate ligament deficiency
ACL deficiency causes instability on pivoting and not patellar tracking.
B. Normal patellar tracking
Normal patellar tracking is smooth and central.
C. Patellar maltracking, as in trochlear dysplasia or patella alta (correct)
Correct. A J-shaped path signals patellar maltracking.
D. Meniscal bucket-handle tear
A bucket-handle tear causes locking and not patellar shift.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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