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PANCE review > MSK > Flashcards

MSK Flashcards

1
Q

What are some inflammatory markers?

A

Elevated ESR and CRP

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2
Q

In joint disease, what is the first line anti-inflammatories used?

A

NSAIDs

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3
Q

MOA of NSAIDs

A

block cytokine synthesis, specifically prostaglandins

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4
Q

Which NSAIDs inhibit both COX-1 and COX-2?

A

ibuprofen, naproxen

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5
Q

Why do some NSAIDs cause increase risk of peptid ulcers?

A

COX-1 inhibition decreases prostaglandin synthesis in gut

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6
Q

Which type of NSAIDs have fewer GI side effects?

A

selective COX-2 inhibitors

drugs ending in “-coxib” (eg. Celecoxib/Celebrex)

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7
Q

Types of inflammatory arthritis

A

RA, spondyloarthritis, infection, crystal-induced

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8
Q

Types of non-inflammatory arthritis

A

osteoarthritis, trauma, hemarthrosis

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9
Q

Inflammatory vs non-inflammatory symptoms

A

Inflammatory - aggravated by rest (eg. prolonged morning stiffness), relief with use, symmetric

Non-inflammatory - aggravated by use, relieved by rest, asymmetric

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10
Q

AC joint connects what?

A

acromion to the clavicle

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11
Q

What are muscles of the rotator cuff? What are their actions?

A 
"SITS"
Supraspinatus – abduction
Infraspinatus – ER
Teres minor – ER
Subscapularis – IR
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12
Q

Which rotator cuff muscles is most often injured?

A

suprapinatus

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13
Q

PE findings of AC joint osteoarthritis

A

Tenderness over AC joint

Cross-arm test (pain cause by flexion and adduction of arm)

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14
Q

Pathophysiology of rotator cuff impingement

A

rotator cuff pinched underneath acromion

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15
Q

Patient comes in because increasing shoulder pain and weakness. Says she can’t lift arm above her shoulder to brush her hair. Likely dx?

A

Rotator cuff tear or impingement

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16
Q

Test that isolates supraspinatus? How is it done?

A

Empty can test: elevate and abduct shoulders with thumbs down. Push down on patient’s arms.

Pain = rotator cuff tear of supraspinatus

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17
Q

What are some PE tests for shoulder impingement?

A

Neer test – Move fully pronated arm in forced flexion (SUBACROMIAL)

Hawkins test – arm is forward elevated to 90 degrees, then forcibly internally rotated (SUPRASPINATUS)

Pain with either is indicative of impingement

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18
Q

How is apprehension test done? What does it test?

A

anterior instability

Arm abducted to 90 deg while examiner externally rotates arm and applies anterior pressure to humerus

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19
Q

Test indicating positive labral tear

A

“clunk sign”
O’Brien test
Speeds (bicep tendonitis)

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20
Q

Test that shows complete rotator cuff tear

A

Drop arm test

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21
Q

Pathophysiology of carpal tunnel syndrome

A

median nerve compression as it runs through carpal tunnel

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22
Q

What forms the carpal tunnel?

A

carpal bones and flexor retinaculum

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23
Q

Which fingers are affected in carpal tunnel?

A

median nerve distribution - thumb, index, middle, radial half of ring finger

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24
Q

What is a sign of severe cases of carpal tunnel?

A

atrophied thenar eminence

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25
Q

Positive tests for carpal tunnel

A

Tinel’s sign - pain and tingling with percussion of flexor retinaculum

Phalen’s Test - press back of hands together (full wrist flexion) and hold, reproduces sx’s within 60 seconds *more accurate than Tinel’s

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26
Q

Diagnostic testing for carpal tunnel

A

EMG testing

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27
Q

Carpal tunnel treatment

A 
Avoid repetitive movements (typing)
Night splint
NSAIDS
Steroid injection
If symptoms constant than need surgical release of flexor retinaculum
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28
Q

Lateral epicondylitis aka _________ and medial epicondylitis aka _________.

A 
lateral = tennis elbow
medial = golfers elbow
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29
Q

Epicondylitis treatment

A 
Rest ice
Injection
Stop repetitive activity
Counterforce brace
Physical Therapy
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30
Q

Etiology of lateral epicondylitis caused by what repetitive movement?

A

wrist supination and extension

  • medial is pronation and flexion
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31
Q

Causes of AC joint separation injury

A

Direct blow

FOOSH

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32
Q

When should AC joint separation be surgically corrected?

A

Type I, II: non-surgical; sling, analgesics, ice

Type III: possible surgery in athletes and heavy laborers

Type IV, V, VI: refer

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33
Q

Most common shoulder dislocation

A

anterior dislocation (95%)

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34
Q

Tests for shoulder dislocation

A

Positive apprehension sign

Positive sulcus sign

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35
Q

How is shoulder dislocation treated?

A

manual reduction

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36
Q

What is a Boxer’s fracture?

A

fracture of 5th metacarpal

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37
Q

Boxer’s fracture treatment

A

Ulnar gutter splint
Closed reduction pinning
ORIF

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38
Q

What is a Colles fracture?

A

distal radius fracture with dorsal angulation of hand and wrist = dinner fork deformity

FOOSH

most common wrist injury

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39
Q

Colles fracture treatment

A

Closed reduction and immobilization

Surgical correction if unable to achieve a stable satisfactory reduction.

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40
Q

Gamekeeper’s Thumb is an injury to what structure?

A

ulnar collateral ligament of thumb

tear or avulsion at insertion on proximal phalanx

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41
Q

Signs of Gamekeeper’s Thumb

A

Instability of the metacarpal joint of the thumb
Weak pinch or grasp
Swelling or bruising of the thenar eminence

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42
Q

Treatment of Gamekeeper’s Thumb

A

Minor tears: thumb spica

Significant tears: surgical repair

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43
Q

Most commonly fractured carpal bone

A

scaphoid

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44
Q

Hallmark finding of scaphoid fracture

A

painful palpation of anatomical snuffbox

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45
Q

Diagnostic imaging for scaphoid fracture

A

MRI, may be missed on XR

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46
Q

Treatment of scaphoid fracture

A

Treat if suspected!
Thumb spica cast
Surgical correction

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47
Q

subluxation of radial head past annular ligament =

A

Nursemaid’s elbow

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48
Q

Nursemaid’s elbow mechanism of injury

A

pulling on extended arm of child

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49
Q

Treatment of Nursemaid’s elbow

A

Reduction: supinate wrist and extend the elbow while applying pressure over radial head

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50
Q

What does a fat pad sign indicate on XR?

A

occult elbow fracture

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51
Q

Time duration of acute vs chronic MSK conditions

A

acute less than 6 wks

chronic more than 12 wks

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52
Q

How to test for herniated disc?

A

+ SLR

L5 nerve effects: decreased ankle and great toe strength, numb medial foot

S1 nerve effects: numb posterior calf and lateral foot, weak plantar flexion, diminished Achilles reflex

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53
Q

What is the narrowing of the spinal canal resulting in compression of spinal cord or nerve roots?

A

spinal stenosis

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54
Q

Causes of spinal stenosis

A 
Herniated disc
Osteoarthritis
Compression fractures
Trauma
Tumor
Inflammation
Congenital - narrow spinal canal
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55
Q

Define radiculopathy

A

pain, weakness or numbness radiating down a particular nerve distribution

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56
Q

What is shopping cart sign? What does it indicate?

A

relief of back pain when bending forward and pushing a shopping cart

sign of spinal stenosis

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57
Q

Most herniated discs occur where?

A

L4/L5 and L5/S1

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58
Q

Patient comes in because of…

Saddle anesthesia
Bowel or bladder incontinence
Sexual dysfunction
Pain in the lower extremities

A

Cauda equina syndrome

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59
Q

What nerves make up the caudal equine (“horse tail”)?

A

L2-L5
S1-S5
coccygeal nerve

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60
Q

Treatment of caudal equina

A

Acute onset is an emergency requiring immediate surgical decompression

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61
Q

Chronic inflammatory disease resulting in vertebral fusion =

A

Ankylosing spondylitis

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62
Q

Schober’s test

A

Mark L5 with patient standing
Mark 5 cm below L5 = point 1
Mark 10 cm above L5 = point 2
With the patient bending over, the distance between point 1 and 2 should be greater than 20 cm. If not, this indicates decreased flexion of spine (seen in ankylosing spondylitis)

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63
Q

XR findings of ankylosing spondylitis

A

Bamboo spine

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64
Q

Ankylosing spondylitis treatment

A 
NSAIDs
Opioids
DMARDS
TNF-alpha antagonists
PT
Surgery
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65
Q

Serum positive for HLA-B27. DDX?

A

Ankylosing spondylitis
Psoriatic arthritis
Reactive arthrites (Reiter’s Syndrome)

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66
Q

Medical term for humpback

A

kyphosis

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67
Q

Epidemiology of ankylosing spondylitis

A

M > F

young adults

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68
Q

Treatment of kyphosis

A

Bracing
Physical therapy
Kyphoplasty

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69
Q

Clinical definition of scoliosis

A

spinal curvature of more than 10 degrees from side to side

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70
Q

What is evaluated on XR of scoliosis?

A

Cobb angle: line parallel to superior endplate of one vertebra and another line parallel to inferior plate of another vertebra; angle at which these two lines intersect is Cobb angle

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71
Q

Treatment of scoliosis

A

Based on Cobb angle

  • Less than 20: watchful waiting, bracing may arrest further deformity
  • Over 50: posterior spinal fusion surgery
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72
Q

What is the minimum you should wait to order imaging on a patient with generalized low back pain and no significant history?

A

4 weeks

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73
Q

All open fractures should include what treatment?

A

Irrigation and debridement within 8 hrs of injury

Empirical abx: 1st gen cephalosporin (cephalexin, keflex)

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74
Q

Risk factors for Avascular necrosis of femoral head

A 
Long term steroid use
Alcoholism
Trauma
Arterial embolism
Sickle cell anemia
Autoimmune disorders like Lupus or RA
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75
Q

Symptoms of avascular necrosis of femoral head

A

groin pain

difficulty walking

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76
Q

Treatment of avascular necrosis of femoral head

A

Core decompression

Total hip replacement

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77
Q

PE tests done in infants to assess for developmental dysplasia of the hip

A

Barlow maneuver – flex hips and knees to 90 deg. Abduct and IR hips while applying pressure to knees in effort to dislocate hips

Ortolani maneuver – flex hips and knees to 90 deg and ER hips while applying pressure over greater trochanters. Done after Barlow to reduce hip if dislocated; positive if clunk

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78
Q

Developmental dysplasia of the hip treatment

A

Bracing and splinting

Surgical correction and possibly total hip

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79
Q

How does leg present on PE when there is a proximal femur fracture?

A

injured leg is short and externally rotated

80
Q

Treatment of proximal femur fracture

A

Needs surgical repair

81
Q

Typical patient with slipped capital femoral epiphysis

A

13 yo overweight male

82
Q

Symptoms of slipped capital femoral epiphysis

A

groin and knee pain

limping a little for few months

83
Q

What of hip is most comfortable for patient with slipped capital femoral epiphysis?

A

ER of hip

pain with IR, abd, and flexion

84
Q

XR views for hip

A

AP and frog leg

85
Q

Treatment of slipped capital femoral epiphysis

A

Surgical correction, consider bilateral

86
Q

patella fracture treatment

A

Displaced - ORIF

Non-displaced - extension brace x 6 wks (CANNOT FLEX)

87
Q

What fractures are likely to occur from a fall from heights where patient lands on feet?

A

tibial plateau tx
calcaneus fx
lumbar compression fx
Lis-Franc fx/dislocation

88
Q

Complication of tibial plateau fracture

A

compartment syndrome

89
Q

What test to do if patella fracture suspected?

A

SLR

90
Q

13 yo male basketball player comes to clinic complaining of anterior knee pain. On PE you note enlarged tibial tubercle and pain with resisted knee extension. Likely dx?

A

Osgood-Schlatter disease

91
Q

Treatment of Osgood-Schlatter disease

A

NSAIDs
Self-limiting, but not until growth plates close
RICE
PT

92
Q

Function of medial and lateral meniscus

A

provide cushion and stability for knee

93
Q

Mechanism of acute meniscus injury

A

twisting of knee with planted foot

94
Q

PE findings of meniscal injury

A 
Joint line tenderness
Joint effusion
pain/click with McMurray
Apply
Thessaly
95
Q

How is McMurray test done?

A

Pt lies supine with knee completely flexed. Passively extend while rotating leg and applying pressure to side of knee

IR for lateral meniscus
ER for medial meniscus

96
Q

ACL prevents anterior translation of ______.

A

tibia

97
Q

PE tests for ACL integrity

A

Anterior drawer: patient supine with knee flexed to 90. You sit on foot and pull on tibia

Lachman test: knee at 30 deg flexion; push down on distal femur and pull up on proximal tibia

98
Q

Single best choice to test for ACL tear

A

Lachman test

99
Q

Likely injury in MVA when knee hits dashboard

A

PCL tear

100
Q

Postitive PE tests if PCL tear

A

Posterior sag sign: hip and knee flexed to 90. see tibial step off

Posterior drawer test: knee flexed to 90 and push proximal tibia

101
Q

How to test integrity of MCL?

A

apply valgus stress to knee at 30 degrees of flexion

102
Q

Treatment for most knee injuries

A

RICE
PT
Surgery

103
Q

Most common structure injured in ankle sprain

A

ATFL = anterior talofibular ligament

104
Q

What is a Jones fracture?

A

fracture at metaphyseal-diaphyseal junction of 5th metatarsal

105
Q

Risk factors for Achilles tendon rupture

A

elderly, florquinolones (cipro), CS tendon injections, sports with explosive jumping

106
Q

What test differentiates Achilles tendonopathy from a full rupture?

A

Thompson’s test positive in rupture (squeeze calf and foot doesn’t move)

107
Q

Patient says “feels like I’m standing on a marble” or “there’s a pebble in my shoe.” This makes you think what dx?

A

Morton’s neuroma

108
Q

Treatment of corns

A

Salicylic acid pads or plaster

Debulk or pare in office with scalpel

109
Q

Pathophysiology of plantar fasciitis

A

Thickened fibrous aponeurosis under calcaneus

110
Q

Common presentation of plantar fasciitis pain

A

Worse in morning
Improved w/ activity, but returns so after
Pain with dorsiflexion

111
Q

Which fifth metatarsal fracture has a high rate of nonunion?

A

Jones fracture

112
Q

Most common pathogen of osteomyelitis? Most common in sickle cell anemic patient?

A

staph aureus

sickle cell - Salmonella

113
Q

infection of the bone =

infection of the joint =

A

osteomyelitis

septic arthritis

114
Q

Treatment of osteomyelitis and septic arthritis

A

At least 6 weeks of antibiotics
Surgical debridement
Remove any hardware (plates, screws etc)

115
Q

Causes of septic arthritis and osteomyelitis

A

Hematogenous (blood) pathway from another infection

Penetrating trauma or surgery

116
Q

Most common pathogen of septic arthritis

A

staph aureus

117
Q

Patient comes in because of leg pain and difficulty walking. There is an open, foul smelling wound on his upper leg. What must you r/o? How?

A

osteomyelitis; bone scan and biopsy

118
Q

How is septic arthritis dx’d?

A

Arthrocentesis (joint aspiration) with WBC > 50,000

119
Q

Most common primary malignancies that metastasize to the bone?

A

prostate, breast, lung cancers

120
Q

Malignant bone tumor commonly in age 10-20 yo? Where is it likely to occur?

A

osteosarcoma; most in knee

121
Q

Most common primary malignant bone tumor in any age

A

Multiple Myeloma

122
Q

Hallmark diagnostic test for Multiple Myeloma

A

serum electrophoresis showing Bence-Jones proteins

123
Q

Multiple Myeloma XR findings

A

“moth eaten” lytic lesions (skull, spine, long bones, ribs)

diffuse osteopenia

124
Q

Prognosis of multiple myeloma

A

death in 4-6 yrs

125
Q

Sunburst lesion on XR =

A

osteosarcoma or Ewing’s sarcoma

126
Q

What should you be suspecting with fatigue, weight loss, and pathologic fractures?

A

Bone tumors

127
Q

Imaging to see spread of bone cancer

A

Bone scan

PET

128
Q

Treatment of bone tumors

A

Chemo and radiation work well on Ewing’s sarcoma

Surgical resection of tumor, including amputation

129
Q

What lab is elevated in bone tumor and why?

A

Alk phos elevated due to bone remodeling

130
Q

Patient with bump on back of wrist full of clear fluid. DX and treatment?

A

Ganglion cyst

Tx: Nothing or can treat with aspiration or surgical excision

131
Q

Joint fluid that collects behind knee

A

Baker’s cyst (popliteal)

132
Q

65 yo patient comes in with decreased ROM and pain in hip. Difficulty walking if weight bearing. XR shows joint space narrowing and osteophytes. Likely dx?

A

Osteoarthritis (Degenerative joint disease)

133
Q

XR findings of osteoarthritis

A

Joint space narrowing
Osteophytes
Bone cysts
Subchondral sclerosis

134
Q

Osteoarthritis treatment

A 
Weight loss
PT and moderate exercise
Tylenol
NSAIDS
Steroid injection
Hyaluronic acid injection
Surgery: Removal of osteophytes, Joint replacement
135
Q

Risk factors of osteoporosis

A 
Age
Female (drop in estrogen)
Family history
Excess alcohol
Malnutrition
Inactivity
Tobacco smoking
Many diseases - Cushing’s, Crohn’s, Cystic fibrosis, Marfans, Renal insufficiency, etc.
136
Q

Gold standard for osteoporosis dx. How is it used to assess severity?

A

DEXA scan

Use T-score to determine severity

  • Normal = more than -1
  • Osteopenia = -1 to -2.5
  • Osteoporosis = less than -2.5
137
Q

Screening recommendations for osteoporosis

A

all women over 65

138
Q

Mainstay medical treatment for osteoporosis

A

Bisphosphonates

139
Q

When is compartment syndrome typically seen?

A

after surgery or other trauma, usually tibial fractures

140
Q

6 P’s of compartment syndrome

A 
Pain is often the first sign
Paresthesia
Paralysis
Pulselessness
Pallor
Poikilothermia – cold limb
141
Q

Dx study for compartment syndrome

A

measurement of intracompartmental pressure

142
Q

Treatment of acute compartment syndrome

A

Fasciotomy

143
Q

Fibromyalgia is frequently associated with what other conditions?

A

depression, anxiety, PTSD

144
Q

Possible treatment for fibromyalgia

A

Cognitive behavioural therapy
Antidepressants
Exercise

145
Q

Red, hot, tendery metatarsal joint of great toe

A

gout

146
Q

Joint fluid in gout will contain what?

A

negatively birefringent crystals

147
Q

Diet that helps prevent gout

A

Limit alcohol, organ meats, animal protein

Drink lots of water

148
Q

Acute and chronic gout treatment

A

Indomethacin (NSAID of choice) or steroid injection to reduce inflammation

Acute attacks: Colchicine
Long term tx: Allopurinol

149
Q

MOA of Allopurinol

A

decreases production of uric acid

150
Q

Diagnostic criteria for gout

A

uric acid over 8

  • 1/2 of gout patients will be below this level
151
Q

How is pseudogout different than gout?

A

joint has deposits of calcium pyrophosphate (positive axis) instead of uric crystals (negative, needle-shaped)

152
Q

_______ means more tan 5 joints involved in JRA and _______ is fewer than 5.

A

polyarticular

oligoarticular

153
Q

Systemic JRA has what hallmark signs

A

Rash
Fever
Hepatosplenomegaly
Hepatits

154
Q

Epidemiology of juvenile rheumatoid arthritis

A

Age less than 16

Girls > Boys

155
Q

What additional features are seen in oligoarticular subtype of JRA?

A

eye issues

156
Q

JRA treatment

A

NSAIDs

PT/OT

157
Q

Epidemiology of polyarteritis nodosa

A

Men 3x more

40-60 yo

158
Q

I came in to see my physician assistant because of…

Insidious onset of proximal muscle weakness
Difficulty going up stairs and getting up from a chair
Dysphagia
Butterfly facial rash

A

Polymyositis

159
Q

Enzymes elevated but not specific to Polymyositis

A

CPK, AST/ALT, LDH, myoglobin

160
Q

Tissue biopsy of polyarteritis nodosa will show what?

A

vasculitis of medium and small vessels

161
Q

Treatment of polyarteritis nodosa

A

high dose steroids

162
Q

Treatment of Polymyositis

A

high dose steroids

163
Q

Dx test of Polymyositis

A

muscle biopsy

164
Q

I came in to see my physician assistant because of…

Constitutional symptoms -fever, weight loss, fatigue
Abdominal pain
Neuropathy
Skin issues
Rashes
Ulcers
Livedo reticularis – a mottled purple skin discoloration

A

Polyarteritis nodosa

165
Q

Temporal arteritis commonly associated with what rheumatologic pathology?

A

Polymyalgia rheumatica (PMR)

166
Q

How is Polymyalgia rheumatica differentiated from other muscle conditions?

A

pain in many muscles
often symmetrical
weight loss
fever

167
Q

Polymyalgia treatment

A

Low dose corticosteroids (10-20 mg prednisone) for several years
Exercise

168
Q

What two pathologies have butterfly facial rash?

A

Lupus

Polymyositis

169
Q

Patient with recent Chlamydia infection comes to clinic c/o joint pain in random places. You note conjunctivitis on EENT exam. Likely dx?

A

Reiter’s Syndrome (Reactive arthritis)

“Can’t see, can’t pee, can’t climb a tree”

170
Q

Pathophysiology of Reactive arthritis

A

autoimmune response; immune system doesn’t stop fighting a GI or GU infection even when infection is cleared

171
Q

RF and HLA-B27 results of Reiter’s Syndrome

A

RF-

HLA+ in most

172
Q

Treatment of Reiter’s Syndrome

A

Treat underlying infection, usually GI or GU (urethritis of Chlamydia)
NSAIDs
Steroids

173
Q

60 yo females comes in with stiff, swollen joints in hands and feet especially in the morning. Likely dx?

A

Rheumatoid arthritis

174
Q

Swan neck deformity

A

PIP hyperextension with DIP flexion

175
Q

Boutonniere deformity

A

PIP flexion and DIP hyperextension

176
Q

Immunologic studies for RA eval

A

RF+ (rules in, but RA pt may be RF-)
ANA
ACPA

177
Q

Synovial fluid of inflammatory vs non-inflammatory arthritis

A

Inflamm: cloudy, WBC >2,000 (>75% PMN), +/- crystals, low viscosity

Non-inflamm: clear, WBC under 2,000, high viscosity

178
Q

Treatment for RA apart from NSAIDs

A

COX-2 inhibitors (Celebrex)

DMARDS: Methotrexate first line (teratogenic!)

179
Q

______ is always seen in Lupus, but not specific.

A

ANA

180
Q

Systemic lupus treatment

A

NSAIDs
Hydroxychloroquine
Steroids

181
Q

Diagnostic criteria for SLE

A

mnemonic: “SOAP BRAIN MD”

Serositis
Oral ulcers
Arthritis
Photosensitivity
Blood disorders
Renal involvement
Antinuclear antibodies
Immunologic phenomena (eg, dsDNA; anti-Smith [Sm] antibodies)
Neurologic disorder
Malar rash
Discoid rash
182
Q

Signs of Raynaud’s

A

hands turn blue and white in cold weather

183
Q

CREST syndrome

A

Seen in scleroderma

Calcinosis (nodules under skin)
Raynaud's
Esophageal problems
Sclerodactyly
Telangiectasias
184
Q

Signs of scleroderma

A

CREST syndrome + joint pain and decreased ROM

185
Q

Scleroderma treatment

A

No cure - symptomatic therapy

Warmer weather and vasodilators (CCBs, alpha blockers) for Raynauds
Steroids for joint pain
Antacids for esophageal sx’s
ACE-I for kidney issues

186
Q

Dx tests for Sjogren Syndrome

A

Schirmer’s test for dry eyes
Rose Bengal test for lacrimal gland function
ANA
RF

187
Q

Pathophysiology of Sjogren Syndrome

A

destruction of salivary and lacrimal glands

188
Q

Sjogren Syndrome treatment

A

Symptomatic treatment - NSAIDs, eye drops, vaginal lubricants, regular dental care

189
Q

Which type of arthritis affects DIP joints of hand? and which affects PIP and MCP?

A

osteoarthritis - PIP, DIP

RA - MCP, PIP

190
Q

Which pathologies cause polyarticular arthritis?

A

RA
Hep B/C
SLE

191
Q

Salter-Harris Fracture Classification

A

fractures in children = “SALTER”

I: Separated
II: Above growth plate (plate and metaphysis)
III: Lower than growth plated (plate and epiphysis)
IV: Through all three
V: cERush injury of plate

192
Q

Torus Fracture

A
  • “Buckle Fracture”
  • Compression fracture of a long bone
  • Typically in children and near metaphysis
  • Can splint, cast or removable Velcro splint x 3wks
193
Q

Galeazzi Fracture

A 
- Triad:
     o Radius Fracture
     o Radius Shortening
     o Radio-ulnar dislocation
- Rare in children
- Surgery required
194
Q

Mallet finger treatment

A

STAX spint to hold DIP in hyperextension x 6wks

195
Q

6 types of AC separations

A

Type I – Minimal to no displacement (sprain)

Type II- Partial separation with complete tear of the acromioclavicular (AC) ligament

Type III- Complete tear of the AC ligament with partial tear or sprain of the coracoclavicular ligaments, a small defect or bump may be seen on physical exam

Type IV- Complete tear of the AC ligament with complete tear of the coracoclavicular ligaments and posterior displacement of clavicle

Type V- Complete tear of AC and coracoclavicular ligaments with 100% displacement superiorly just under skin

Type VI- Complete tear of the AC and coracoclavicular ligaments with displacement inferiorly under the coracoids (not very common)

PANCE review (18 decks)

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