American Board of Internal Medicine (ABIM) Certification Practice Exam

What type of injury is characterized by pain and instability when pivoting?

1. Meniscus tear

2. Anterior cruciate ligament tear

3. Patellar dislocation

4. Hamstring strain

The correct answer is: Anterior cruciate ligament tear

The type of injury characterized by pain and instability when pivoting is typically an anterior cruciate ligament (ACL) tear. The ACL is a crucial ligament in the knee that helps stabilize the joint, particularly during movements that involve stopping, pivoting, or changing direction. When the ACL is torn, individuals often experience significant pain and a feeling of instability in the knee, especially during activities that require twisting or pivoting motions. In sports and physical activities, when an athlete pivots suddenly, especially if they land awkwardly or change direction quickly, the forces can exceed the strength of the ACL, leading to a tear. This injury commonly occurs in sports like basketball, soccer, and football, where sharp turns and jumps are frequent. Other options may also involve knee pain but do not specifically represent the classic symptoms of instability linked directly to pivoting. A meniscus tear, while also painful and associated with knee joint issues, usually presents with locking or catching sensations rather than the acute instability of an ACL injury. Patellar dislocations may lead to instability but generally do not occur solely from pivoting. A hamstring strain primarily affects the muscles in the back of the thigh and would not typically present with knee instability related to pivoting movements.