Sports Injury/MSK/Ortho Flashcards

1
Q

Sprain classifications

A

Grade 1: ligament is stretched.
Grade 2: A partial ligament tear
Grade 3: complete tear of the ligament

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2
Q

Ottowa Ankle Criteria

A

Radiographs of the ankle are indicated for individuals
1. Unable to bear weight on the affected ankle
2. Tenderness involving the tip or posterior aspect of the ankle malleoli

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3
Q

Ankle sprains should be treated with _______, if tolerated

A

early mobilization

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4
Q

Pain associated with spondylolysis, what causes it, and how to evaluate

A
  • pain with EXTENSION of lumbar spine and some local radiation
  • caused by repeated sports injury,
  • evaluate by radiology (only 50-60% sensitive), can also evaluate by MRI
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5
Q

Greenstick Fracture
- mechanism of fall

A

outstretched hand
long bone break

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6
Q

Physeal fractures are called

A

Salter-Harris fractures

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7
Q

Define:
Salter-Harris type I
Salter-Harris type II
Salter-Harris type III
Salter-Harris type IV

A

I: bony injury across physis (none to metaphyseal or peiphyseal)
II:
III:
IV: cross 3 regions of bone (epiphysis, physis, mataphysis)

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8
Q

Pain with ambulation in a multisport athlete, better with resting, comes right back with exercise. Dx?

A

Femoral neck stress fracture

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9
Q

Evaluation of and Management of femoral neck stress fracture

A

Passive leg roll with reproduction of joint pain
MRI
crutches (fully non-weight bearing)
Screw-fixation

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10
Q

Management of femoral anteversion “knock-knees”

A

reassurance if asymptomatic
Close re-evaluation if intermalleolar distance is 7 cm or more

If knee pain, hip pain, or restricted hip ROM, hip XR

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11
Q

Management of in-toeing

A

If before 6-8 yo, reassurance

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12
Q

Cause of in-toeing
<3 yo
>3 yo

A

<3 yo: internal tibial torsion
>3 yo: femoral anteversion

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13
Q

Adolescent has congenital scoliosis, next step?

A

renal ultrasound

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14
Q

Diagnosis of congenital scoliosis

A

Malformation of vertebra (wedge formation)

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15
Q

When should you refer to orthopedic surgeon in scoliosis? When is surgery indicated?

A

Referral: > 20 degrees

Surgery:
progression > 10 degrees per year OR
>40 degrees
>50 degrees in skeletly mature individuals (will progress)

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16
Q

Management of stress fracture through growth plate from “little league shoulder”

A

cessation of use for 3 months
Sling if there is significant discomfort at rest or pain with ADL

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17
Q

Inferior patellar pain bilateral, worse with resisted knee extension, no ligamentus laxity noted. Dx?

A

Distal patellar apophysitis (Sinding-Larsen-Johansson syndrome SLJS)

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17
Q

Inferior patellar pain bilateral, worse with resisted knee extension, no ligamentus laxity noted. Dx?

A

Distal patellar apophysitis (Sinding-Larsen-Johansson syndrome SLJS)

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18
Q

Pain in tibial tuberosity

A

Osgood-Sclatter

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19
Q

gradual onset of diffuse anterior patellar pain after period of increased activity

A

patellofemoral syndrome

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20
Q

Gradual onset of pain along patellar tendon after a period of increased high intensity running +/- jogging

A

patellar tendinitis

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21
Q

When should valguss knee deformity (knock-knee) resolve by

A

2 yo - 4 yo

22
Q

When should varus/valgus deformity be evaluated further?

A

Valgus onset before age 2
>7 yo with intermalleolar distance > 8 cm
+ pain/swelling
Prior trauma
Abnormal growth curve

23
Q

Evaluation of septic arthritis

A

ultrasound of joint to rule out/in effusion

24
Q

Abx of septic arthritis

A

cover staph and strep, kingela

Unasyn/zosyn and 3rd gen cephalosporin to cover H. flu and gonorrhea

25
Q

When does surgical intervention need to happen in septic arthritis

A

hip or shoulder joint

26
Q

Atraumatic groin pain in adolescent ddx

A

femoroacetabular joint pathology
- femoroacetabular impingement
- acetabular labrum tear “C-sign”
- femoral neck stress fracture
- hip flexor tendinitis +/- bursitis

27
Q

What syndrome/disease is associated with Leg-length dyscrepancy

A

Wilms tumor

28
Q

Management of leg-length discrepancy

A

Skeletally immature
<2 cm: reassess every 6-12 mo
2-6 cm: surgical referral for possible epiphysiodesis (destruction of growth plate)
>6 cm: surgical referral for possible limb lengthening or prosthetic fitting

Skeletally mature
<2 cm: reassureance or heel lift if symptomatic
2-6 cm: surgical referral for possible limb-shortening procedure
>6 cm: surgical referral for possible limb lengthening or prosthetic fitting

29
Q

Management of leg-length discrepancy

A

Skeletally immature
<2 cm: reassess every 6-12 mo
2-6 cm: surgical referral for possible epiphysiodesis (destruction of growth plate)
>6 cm: surgical referral for possible limb lengthening or prosthetic fitting

Skeletally mature
<2 cm: reassureance or heel lift if symptomatic
2-6 cm: surgical referral for possible limb-shortening procedure
>6 cm: surgical referral for possible limb lengthening or prosthetic fitting

30
Q

Pathophys of osteogenesis impefecta

A

abnormality in type 1 collagen

COL1A1, COL1A2

31
Q

Respiratory sequelae of osteogenesis imperfecta

A

small chest cavity = restrictive disease

32
Q

How do you monitor hip joints in infants with osteogenesis imperfecta?

A

Hip ultrasound

33
Q

Heel pain in athlete, dx and management

A

Sever apophysitis (injured calcaneal growth plate)
Management: heel cups or cushions

34
Q

What ages should one be evaluated for scoliosis

A

Girls: 10 and 12 yo
Boys: 13 and 14 yo

35
Q

What is considered positive screening for scoliosis and what is the next step

A

> 5-7 degrees

Radiographs of the spine

36
Q

Radiologic finding of legg-calve-perthes (femoral head AVN) and next steps

A

radiolucency of femoral head
crutches and non-weight bearing status

37
Q

Radiologic finding of legg-calve-perthes (femoral head AVN) and next steps

A

radiolucency of femoral head
crutches and non-weight bearing status

38
Q

Where is the most reassuring place for polydactyly on a hand?

A

postaxial (ulnar/fibular aspect)

39
Q

Pattern of development in children with achondroplasia

A

Delayed gross motor development

40
Q

What is the normal passive rotational and lateral flexion range of neck in children 0-3?

A

110 degrees on each side (rotational)
70 degrees on each side (lateral flexion)

41
Q

If congenital muscular torticollis continues after 6 mo of therapy, what is the next step?

A

radiography

.. if >1 year, maybe surgery

42
Q

Visual acuity cut off for athletes

A

if 20/40 uncorrected, need to go get glasses
if best is 20/40, then need additional eye protection

43
Q

Difference in management of flexor tendon vs. extensor tendon injury of the hand

A

flexor = surgical referral
extensor = conservative

44
Q

What is the “neck rule”

A

above the neck, ok to play for athletes
Below the neck symptoms (pna, emesis, systemic), should be withheld from sports

45
Q

Tackled kid has injury to lateral neck…symptoms resolved with free ROM of neck, but still weakness of shoulder abduction and elbow flexion. Next steps?

A

watch for resolution

“stinger” or “burner”

46
Q

After concussion, what is the medical clearance protocol

A

Full symptom resolution, return to prior levels of academic performance, no symptom recurrence with physical activity.

47
Q

Pitcher throwing with medial elbow pain that is worsening, now with swelling. Next step?

A

Bilateral elbow xray to assess for medial apophysitis or progression to avulsion

Need bilateral to assess subtle changes in growth plate alignment

47
Q

Pitcher throwing with medial elbow pain that is worsening, now with swelling. Next step?

A

Bilateral elbow xray to assess for medial apophysitis or progression to avulsion

Need bilateral to assess subtle changes in growth plate alignment

48
Q

Management of medial apophysitis of elbow

A

cast immobilization for 2-3 weeks
if >2 mm displacement, possible surgical fixation

49
Q

Recommendation for Osgood-Schlatter

A

spend at least 2-3 mo/yr away from structured sports participation

50
Q

Girl with syncope during exertion and no other symptoms after. No family history of cardiac deaths. Next steps?

A

Cardiac clearance.

51
Q

Recurrent ankle injuries, management

A

Radiography IF:
tenderness along posterior edge, tip or distal 6 cm of tibia or fibula OR inability to bear weight immediately after injury in the office

Otherwise, PT

52
Q

healthy rate of weight loss for adolescents is no greater than __

A

1.5% of body weight per week