Intro

Question 1

Ortho Hx in general

Answer 1

Pain
Locking / Catching
Instability / Dysfunction
"Give way"
Traumatic / Atraumatic
Fever, Chills, Weight Loss
Hx of ca, rheumatologic d/o, infection
Handedness

Question 2

Ortho Physical Exam

Answer 2

Inspection
Palpation
ROM
Special tests
Muscle strength
Nerve Roots

Question 3

Inspection

Answer 3

Swelling
Erythema
Ecchymosis
Symmetry / length (compare side to side)
Joint deformity
Atrophy
Scars
Standing posture
Gait

Question 4

Palpation

Answer 4

Swelling / effusion
Crepitus
Tenderness
Masses
Fluctuance
Temperature changes

Question 5

Special Test

Answer 5

specific for each joint

Question 6

Muscle Strength - Oxford Scale

Answer 6

0 - No contraction
1 - Visible / palpable muscle contraction but no movement
2 - Movement with gravity eliminated
3 - Movement against gravity only
4 - Movement against gravity with some resistance
5 - Movement against gravity with full resistance

Question 7

Imaging - examples

Answer 7

Standard radiographs
MRI
PET
CT

Question 8

Standard radiographs

Answer 8

Common
Assess for arthritis, fx, dislocations and others
Some soft tissue findings

Question 9

MRI

Answer 9

soft tissue - internal derangement; herniated disc; occult fx

Question 10

MRI athrogram

Answer 10

further evaluation of joints

Question 11

PET

Answer 11

Tumors

Ca

Question 12

CT

Answer 12

Bony detail

Esp. fx

Question 13

Special Test - Examples

Answer 13

Arthrocentesis
NCS
Labs

Question 14

Arthrocentesis

Answer 14

Remove fluid from joint for evaluation

ie - infection; gout

Question 15

NCS

Answer 15

Done for numbness or other neurological concerns

Gives a rough location of neurological deficit
ie CTS, ulnar neuropathy

Question 16

Labs

Answer 16

ESR
CRP
CBC - infection

Question 17

Tx - in general

Answer 17

RICE / MICE
Medications
Immobilization
Rehab

Question 18

RICE / MICE

Answer 18

Rest or modification of activity
Ice
Compression
Elevation

Question 19

Medications

Answer 19

NSAIDs
Acetaminophen
Pain meds
Glucosamine chondroitin 
Steroid
Viscosupplementation
Muscle relaxer

Question 20

Immobilization

Answer 20

Casting
Splinting
Bracing

Question 21

Rehab

Answer 21

PT
OT
Athletic Training

Question 22

Acetaminophen

Answer 22

common analgesic for mild to moderate pain
Often prescribed in OA and other ortho dz with pain
Do not exceed 4,000 mg in 24h
Can be hard on the liver
No anti-inflammatory properties

Question 23

NSAID

Answer 23

Inhibit cyclooxygenase - the enzyme that converts archidonic acid to prostaglandins
More effective than acetaminophen, but more SE
Most inhibit COX-1 & COX-2
Safer GI profile

Question 24

SE of NSAIDs

Answer 24

Can cause renal toxicity
Risk of GI bleed
Risk of CV problems

Question 25

Examples of NSAIDs

Answer 25

Ibu
Aleve
Naproxen
Diclofenac
Asa
Feldene

Question 26

Examples of Pain medications

Answer 26

Hydrocodone
Oxycodone
Ultram

Question 27

Muscle relaxer

Answer 27

Tx of muscle spasms often causing pain

Question 28

Example of muscle relaxer

Answer 28

Flexeril
Skelaxin
Zanaflex

Question 29

Glucosamine Chondroitin

Answer 29

Taken as supplements

Efficacy varies from pt to pt

Question 30

Viscosupplementation

Answer 30

Medication injected into knee joint to decrease inflammation, decrease pain, provide nutrients to knee and lubricate knee

Tx of early arthritis

Question 31

Examples of Viscosupplementation

Answer 31

Synvisc
Hyalgan
Orthovisc
Eufflexa

Question 32

Steroid

Answer 32

Potent anti-inflammatory agent
Decreases inflammation and pain
Intra-articular or po

Question 33

SE of steroid

Answer 33

Deterioration of bone / joint
Skin/fat atrophy
Osteoporosis