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year 2 loco > 5. Soft tissue diseases > Flashcards

5. Soft tissue diseases Flashcards

1
Q

What are the red flags for severe disease?

A 
Fever
Unexplained weight loss
History of carcinoma 
Immunosuppression 
Ill health or presence of other medical illness
Severe night pain/progressive pain 
Persistant mono-arthritits
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2
Q

What are yellow flags?

A

These are factors that increase pain and the risk of developing or perpetuating long term disability and work loss associated with persistent pain

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3
Q

What is meant by the ‘enthesis’?

A

This is the area of the ligamentous attachment to bone - where the tendon sheath inserts into the bone

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4
Q

What is ‘tendonitis’ characterised by?

A

Characterised by pain on resisted movement

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5
Q

What is De Quervain’s tenosynovitis?

A

Inflammation of the tendons on the side of the wrist at the base of the thumb

Type of tendonitis

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6
Q

Where is pain felt in De Quervain’s tenosynovitis?

A

Around the thumb, at the base of the thumb and at the wrist

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7
Q

Which tendons are affected in De Quervain’s tenosynovitis? x3

A

Extensor pollicis brevus
Abductor pollicis longus
Extensor pollicis longus

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8
Q

Other than pain, how does De Quervain’s tenosynovitis present?

A

Crepitus on movement

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9
Q

How is De Quervain’s tenosynovitis treated?

A

Topical anti-inflammatory medication e.g. ibuprofen

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10
Q

How is De Quervain’s tenosynovitis tested? x3

A

Pain on resisted movement (!)
Crepitus
Finkelstein’s test

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11
Q

What is trigger finger?

A

Nodule on the relevant flexor/tendon forms - gets stuck passing through the tendon sheath of the palm

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12
Q

How is trigger finger treated?

A

Topical anti-inflammatories

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13
Q

What is carpal tunnel syndrome?

A

Compression of the median nerve in the carpal tunnel

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14
Q

How does carpal tunnel syndrome present?

A

Presents as pain and parasthesia due to sensory loss first thing in the morning

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15
Q

What is the effect of advanced carpal tunnel syndrome?

A

Atrophy of the thenar eminence

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16
Q

What other conditions are closely associated with carpal tunnel syndrome?

A 
Hypothyroidism
RA
Diabetes
Pregnancy 
Acromegaly
17
Q

Name the two tests used to diagnose carpal tunnel syndrome

A

Tinel’s test

Phalen’s test

18
Q

What is Tinel’s test?

A

Tap/percuss on the medial nerve

Should illicit sensation of tingling over the distribution of the nerve

19
Q

What is Phalen’s test?

A

Push the wrists into complete and forced flexion

20
Q

How can you treat carpal tunnel syndrome?

A

Immobilise the joint
Inject steroids to release inflammation

All treatment is aimed at decompression of the median nerve

21
Q

What is dupuytren’s contracture?

A

Fibrosis of the palmar aponeurosis causing the fingers to bend inwards

22
Q

In whom is dupuytren’s contracture most common?

A

Men
Heavy drinkers
Smokers
Diabetics

23
Q

What is tennis elbow?

A

Inflammation of the enthesis where of the extensor muscles of the forearm at the lateral epicondyle of the humerus

24
Q

What is tennis elbow also known as?

A

Lateral epicondylitis

25
Q

How is tennis elbow diagnosed?

A

Local tenderness

Pain at resisted wrist extension

26
Q

What is the treatment for tennis elbow?

A

Rest/topical NSAID
Massage
Injection
In severe cases - surgery

27
Q

What is the dermatomal distribution of true shoulder pain?

What is not affected by this pain?

A

C5

The elbow

28
Q

What is the other name for frozen shoulder?

A

Adhesive capsulitis

29
Q

What is frozen shoulder?

A

Capsulitis - the capsule of the shoulder joint becomes thickened and very adherent - glues up - becomes sticky and gooey

30
Q

What happens to the size of the joint capsule of the shoulder in frozen shoulder?

A

The whole capsule shrinks and there is a reduced area of space for movement

31
Q

What is the cause of frozen shoulder?

A

Idiopathic

32
Q

What is the treatment for frozen shoulder?

A

Re-assurance/education
Analgesia
Injection
Physiotherapy

33
Q

What is rotator cuff tendinitis?

A

Impingement of the rotator cuff muscles between the greater tuberosity and the acromium- common in young athletes where there is overuse

34
Q

How does rotator cuff tendinitis present?

A

Painful arc on active abduction

Pain on resisted abduction

35
Q

What is the treatment for rotator cuff tendinitis?

A

Physiotherapy
Steroid injection
Surgery may be considered if this does not settle

36
Q

What is meralgia paraesthetica?

A

This is the hip equivalent of carpal tunnel syndrome

37
Q

What is ‘march fracture’?

A

This is a fatigue/stress fracture of the distal third of the metatarsal due to recurrent stress (marching)

38
Q

What is mortons neuroma?

A

Benign neuroma at the planter nerve of the foot

39
Q

Meralgia paraesthetica - compression of which nerves?

A

Lateral cutaneous nerves

year 2 loco (31 decks)

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