DUMS ortho Flashcards
(53 cards)
<p>What type of tumour has causes a bony outgrowth with a cartilaginous cap and what symptoms does it have?</p>
<p>Osteochrondroma
Local pain</p>
<p>What is the chance of malignancy in an osteochrondroma?</p>
<p>1%</p>
<p>Where is an enchondroma found?</p>
<p>Intramedullary (usually metaphyseal) </p>
<p>How does an enchondroma present?</p>
<p>Usually asymptomatic (may cause pathological fracture),
| Incidental finding on X-ray (lucent lesion) </p>
<p>How is an enchondroma treated?</p>
<p>Curettage and bone graft</p>
<p>What are the 2 types of bone cyst and how do they present?</p>
<p>Simple: fluid filled (asymptomatic)
| Aneurysmal: blood filled (pain and weakness)</p>
<p>How is a bone cyst managed?</p>
<p>Curettage and bone graft</p>
<p>How does an osteoid osteoma appear?</p>
<p>Small nub of bone surround by intense sclerotic halo </p>
<p>How does an osteoid osetoma present?</p>
<p>Intense constant pain, worse at night (due to inflammatory response) </p>
<p>How is an osteoid osteoma diagnosed and managed?</p>
<p>X-ray
NSAIDs to relieve pain
CT guided radiofrequency ablation </p>
<p>What is the most common malignant bone tumour and who does it present in?</p>
<p>Osteosarcoma Young patients (usually around knee)</p>
<p>What tumour presents with fever and inflammatory makers (similar to osteomyelitis) in young patients </p>
<p>Ewings sarcoma </p>
<p>What disease presents with multiple fragility fractures in childhood, loss of hearing and blue sclera?</p>
<p>Osteogenesis imperfecta (brittle bone)</p>
<p>What is dwarfism referred to as and what facial features are seen?</p>
<p>Skeletal dysplasia
| Prominent forehead and wide nose </p>
<p>What gene is mutated in marfans syndrome?</p>
<p>Fibrillin gene </p>
<p>What is Gowers sign associated with?</p>
<p>Duchenne muscular dystrophy (due to proximal leg weakness)</p>
<p>What is the genetic defect in Muscular dystrophy and how is it diagnosed?</p>
<p>Dystrophin gene (assoc with ca)
| Raised serum creatinine phosphokinase + abnormal muscle biopsy </p>
<p>What is DDH and how is it investigated?</p>
<p>Developmental dysplasia of the hip
USS
Present with shortened limb</p>
<p>What group does transient synovitis commonly present in and how is it managed?</p>
<p>Young boys after viral infection
| Rest and NSAIDs</p>
<p>What is Perthes disease?</p>
<p>Idiopathic inflammation of femoral head, loss of blood supply, necrosis and abnormal growth</p>
<p>How does Perthes disease present?</p>
<p>Pain and limp in active boys </p>
<p>What is SUFE and who does it present in?</p>
<p>Slipped upper femoral epiphysis (growth plate can't cope with weight)
Overweight children</p>
<p>What is club foot and how is it managed?</p>
<p>Congenital deformity of talus, calcaneus and navicular joint
Splintage + gradual correction in 4-6 week blocks</p>
<p>Where are rotator cuff tendons impinged during a painful arc?</p>
<p>Subacromial space </p>
What muscle is most commonly injured in a rotator cuff tear and how is it managed?
Supraspinatous | Surgery or physio
What is adhesive capsulitis and how is it managed?
Frozen shoulder | Self-resolving over 18-24 months (+steroids)
What is a Bankart repair used for?
Recurrent shoulder dislocations
What nerve is affected in carpal tunnel and cubital tunnel syndrome?
Carpal tunnel: median | Cubital tunnel: ulnar
What causes the pain in tennis and golfers elbow and how is it managed?
Micro-tears in the tendons | Rest, NSAIDs and steroids
What causes Dupuytren's contracture? What groups of people is it more common in?
Proliferation of type 3 collagen fibres (proliferative connective tissue disorder) Alcoholics, diabetics
How is Dupuytren's managed?
Fasciectomy (surgical release of collagen fibres) if greater than 30 degrees
What causes trigger finger?
Tendonitis of a flexor tendon to a finger (enlarges and catches on the fascia - causes a clicking sensation)
How is trigger finger managed?
Injection of steroid around the tendon to relieve symptoms Surgery
What is a ganglion cyst?
Mucinous filled cyst by a tendon or synovial joint (mostly cosmetic issues)
How is a ganglion cyst investigated and managed?
Transillumiation to ensure not pathological Needle aspiration (temporary relief, common reoccurrence) Surgical excision (only if causing severe discomfort)
```What is trochanteric bursitis and what causes it?
Inflammation of the bursa over the greater trochanter (hip) -> self-limiting Caused by overuse (athletes)
What direction does the shoulder most commonly dislocate?
Anterior (95%)
In a shoulder dislocation which nerve and artery are at most risk of compression?
Axillary nerve (numbness of lateral aspect) | Axillary artery
What nerves and arteries are at risk in a humeral shaft fracture?
Radial nerve | Brachial artery
What is a nightstick fracture?
Isolated fracture of the ulna (usually defensive injury)
What is a Monteggia and a Galeazzi fracture dislocation?
Monteggia: ulnar fracture, dislocation of radial head at elbow Galeazzi: radial fracture, dislocation of the ulna at the wrist
What is a FOOSH?
Fall onto outstretched hand
What is a Colles' fracture?
Distal radial fracture FOOSH Causes dorsal displacement of hand (dinner fork)
What is the opposite of a Colles' fracture?
Smiths fracture Distal radial fracture, Causes volar displacement (requires ORIF, highly unstable)
What X-rays must be taken for a scaphoid fracture? How long until repeat scan if unclear?
AP, Lateral, 2 x oblique | 6 weeks
What is the risk with a scaphoid fracture?
Avascular necrosis (due to retrograde blood supply)
How does a hip fracture appear and where should this be managed?
Shortened + externally rotated | A&E (medial emergency)
What type of hip fracture is higher risk and why is this?
Intracapsular, retrograde blood supply so risk of avascular necrosis to femoral head
How should an intracapsular vs extra capsular hip fracture be managed?
Intra; hemi-arthroplasty (longer lasting, lesser mobility) or total hip replacement Extra; dynamic hip screw (internal fixation)
What bone in the body takes the longest to heal if fractured and what is its definitive management?
Tibia Internal fixation (intermedullary nail)
```What is the salter-harris classification of fractures used for?
Paediatric physeal fractures
What Salter-Harris fractures require intervention and why is this?
Salter-Harris III + IV | High risk of growth arrest as splits the physis
What occurs during a Salter-Harris V injury?
Compression injury to physis causing growth arrest (cannot be diagnosed on initial X-ray)
