Hip and Lower Leg - Conditions Flashcards
(148 cards)
1
Q
what is avn
A
bone infarct
2
Q
which parts of the body are higher risk of avn and why
A
femoral head, scaphoid, talus, lunate, since tenuous BS
3
Q
risk factors for avn
A
alcohol, CCS, hyperlipidaemia, sickle cell
4
Q
investigations for avn of the hip
A
early: mri
late: xr showing hanging rope sign
5
Q
management of ealry and late presentations of avn of the femoral head
A
early; decompression, late; THR
6
Q
another name for irritable hip
A
transient synovitis
7
Q
age and gender most commonly affected by irritable hip
A
boy 2-5yr
8
Q
presentation of irritable hip
A
can’t bear weight after URTI +- pyrexic
9
Q
investigations for irritable hip
A
normal bloods, US effusion
10
Q
irritable hip management
A
self-limiting
11
Q
risk factors for sufe
A
10-16yr black obese male
12
Q
what does sufe stand for
A
slipped upper femoral epiphysis
13
Q
presentation of sufe
A
acute/chronic knee+-distal thigh pain, loss of internal rotation
14
Q
what is sufe
A
femoral epiphysis slips inferior to femoral neck
15
Q
what is seen on xr in sufe
A
Trethowan’s sign
16
Q
SUFE Mx
A
surgical stabilization of physis
17
Q
complication of sufe
A
avn
18
Q
what is perthes disease
A
unilateral transient AVN of femoral head
19
Q
risk factors for perthes disease
A
4-8yr short hyperactive boy
20
Q
what is seen on examination in perthes disease
A
Trendeleberg gait
21
Q
complication of perthes disease
A
oa
22
Q
risk factors for ddh
A
breech, FH, 1st born, girl
23
Q
what does ddh stand for
A
developmental dsyplasia / dislocation of the hip
24
Q
investigations for ddh
A
US, XR; uncalcified epiphysis
25
management of ddh presenting early
palvik harness
26
management of ddh presenting <2yr
reduce + cast
27
presentation of ddh >2yr
trendelenberg, short leg, no pain, >OA
28
what is the 1st sign of hip pathology
loss of internal rotation
29
what is trochanteric bursitis
abductor gluteus medius tendonitis
30
trochanteric bursitis presentation
pain/tender at greater trochanter & on abduction
31
presentation of ddh in newborn
asymmetric skin crease, feel for click
32
what is seen on examination in hip fractures
shortened externally rotated leg. can't SLR
33
classification of hip fractures
intracapsular, extracapsular
34
complications of intracapsular hip fractures
avn, non-union
35
investigations for hip fractures
x-ray showing break in shenton's line
36
management of intracapsular hip fracture in inactive old people
THR or hemiarthroplasty
37
management of intracapsular hip fracture in young people or active old people
internal fixation
38
management of extracapsular hip fractures
ORIF dynamic hip screw
39
infection rate in hip surgeries
5%
40
what are the risks in femoral shaft fractures and what is done to prevent them
blood loss, fat embolus, ARDS. thomas splint
41
management of unstable femoral shaft fracture
IM nail
42
complications of tibial plateau fracture
compartment synd, neurovascular injury
43
risk factor for tibial plateau fracture
op
44
management of tibial plateau fracture
orif or ex-fix
45
describe tibial plateau fracture on x-ray
intra-articular, 80% lateral condyle
46
complication of tibial shaft fracture
compartment s.
47
what is a maisonneuve fracture
proximal tibial fracture + interosseous membrane rupture
48
what is the slowest healing bone
tibia
49
what is a pilon fracture
intraarticular distal tibia# +-fibula / ankle#
50
pilon fracture mx
debride + ex-fix, soft tissue settles ORIF
51
which meniscus is more commonly torn and why
medial since its less mobile
52
menisci function
absorb shock, distribute load from convex femoral condyles to flat tibial articular surfaces
53
function of mcl
resists valgus
54
function of lcl
resists varus & external tibial rotation
55
function of acl
resists anterior tibial subluxation & internal tibial rotation in extension
56
function of pcl
resists posterior subluxation of the tibia & knee hyperextension
57
components of the posterolateral corner
PCL, LC, popliteus & smaller ligaments
58
function of posterolaternal corner
resist tibial external rotation on flexion
59
what types of cartilage are in the knee
hyaline and fibrocartilage
60
consequence of failed extensor mechanism
can’t extend knee or SLR
61
knee deformity caused by rickets
genu varum or genu valgum
62
knee deformity caused by skeletal dysplasia
genu varum
63
complication of genu varum
medial oa
64
complication of genu valgum
lateral oa
65
when to refer genu valgum
asymmetric, pain, >16°/>8cm age 11
66
management of genu varum in an adult
osteotomy
67
what is severe genu varum
>16°
68
what is abnormal genu varum
>6°
69
what is normal knee alignment
6° valgum
70
what is housemaid's knee
prepatellar bursitis
71
what is jumper's knee
Patellar tendonitis
72
jumper's knee mx
self limiting
73
condition associated with baker's cysts
oa
74
pathology of baker's cysts
popliteal synovial fluid outpouching
75
baker's cyst mx
self-limiting
76
what is osgood schlatter
lump at tibial tuberosity
77
presentation of osgood-schlatter's disease
unilateral pain/tenderness worse after exercise in teenager
78
what scan to refer for if suspected meniscus problem
mri
79
presentation of patello-femoral dysfunction
tender knee, worse downhill, teenage girl, clicks
80
imaging to view quadriceps and patellar tendon
us
81
imaging to view cruciate ligaments
mri
82
causes of knee haemarthrosis
ACL ruptur, tibial plateau #, patellar dislocation
83
how quickly do knee haemarthrosis and effusions present
haemarthrosis 1 hour
| effusion 1 day
84
difference in pain between haemarthrosis and effusion
haemarthrosis all over knee, effusion localised to joint line
85
causes of knee effusions
meniscal/chondral injury
86
risk factors for patella dislocation
adolescent valgus female
87
which way does the knee dislocate
laterally
88
management of patellar dislocation
3wk splint
89
management of recurred patellar dislocaion
osteotomy or soft tissue reconstruction
90
complication of knee dislocation
50% popliteal artery injury, also common fibular nerve injury
91
which age are affected by patellar and quadriceps tendon rupture
patellar <40 yr
| quad >40 yr
92
knee injury caused by valgus
mcl
93
mcl injury mx
heals itself
94
lcl injury mx
repair/reconstruct
95
complications of lcl injury
peroneal nerve palsy
96
presentation of acl rupture
pop, haemarthrosis, +ve Lachman test, 50% + mensicular tear
97
management of acl rupture
1/3 reconstruction; patellar tendon / semitendinosus / hamstring / allograft / Achilles / synthetic
98
injury mechanism of acl rupture
internal rotation
99
mechanism of pcl rupture
hyperextension/direct blow
100
examination test postive in pcl rupture
posterior drawar test
101
examination test positive in meniscal tear
steinman
102
management of a meniscal tear in a young patient
arthroscopic repair
103
management of a meniscal tear repair catching/locking in a young patient
arthroscopic menisectomy
104
what surgery can be done for patients over 40 and when is it indicated for meniscal tears
if unstable or pain for >3mth do arthroscopic menisectomy
105
cause of an acute locked knee
bucket handle meniscus tear
106
how to diagnose bucket handle meniscus tear
mri
107
what is a complication of bucket handle meniscus tears
ffd fixed flexion deformity
108
management of a meniscal tear in patients over 40yrs
ccs injection
109
classification of pes planus
flexible or fixed
110
age and gender affected by tibialised posterior dysfunction
40-50 female
111
presentation of tibialis posterior dysfunction
adult acquired flat foot, progressive midfoot/ankle pain,
112
management of tibialis posterior dysfunction
no CCS, synovectomy
113
intoeing pathology
femoral neck anteversion, internal tibial torsion, metatarsus adductus
114
club foot aka
Talipes equinovarus
115
club foot mx
Ponseti splint +- tenotomy
116
condition associated with club foot
ddh
117
bunion aka
Hallux valgus
118
risk factors for hallux valgus
>age, female, high heel, RA
119
toe affected by hallux valguss
big toe or pinky
120
management of hallux valgus
conservative -> osteotomy
121
what is hallux rigidus
1st MTPJ OA
122
management of hallux rigidus
change shoe, wait 2 yr -> cheilectomy/arthrodesis
123
high arched feet aka
pes cavus
124
what is hallux valgus
1st metatarsal medial deviation lateral toe deviation
125
age and gender affected by morton's neuroma
female 45-55
126
pathology of morton's neuroma
digital nerve fibrosis -> neuroma
127
presentation of morton's neuroma
forefoot burn/tingles, Mulder’s click test
128
diagnosis of morton's neuoma
us
129
management of morton's neuroma
insole, nerve injection, surgical excision
130
plantar fasciitis prsentation
pain on exercise, swell/tender
131
plantar fasciitis mx
NSAID, splint, rest, CCS injection, 50% success surgery
132
achilles tendinopathy pathology
repetitive microtrauama collagen repair failure
133
achilles tendinopathy presentation
morning stiff, pain better w/ walking
134
achilles tendinopathy dx
clinical diagnosis or US
135
achilles tendinopathy mx
splint, activity, analgesia, NSAID, PT
136
tendo-achilles rupture presentation and which examination test is positive
can’t bear weight, weak plantarflexion, Simmond’s test
137
tendo-achilles rupture mx
no CCS, cast or surgery
138
does an ankle fracture or sprain take longer to heal
sprain
139
when to xr a suspected ankle sprain
bony tenderness or can’t bear weight
140
what is an unstable ankle fracture
bimalleolar, >1cm talar shift XR
141
management of stable ankle fracture
6wk boot
142
management unstable ankle fracture
orif
143
what is a lisfranc injury
2nd TMTJ avulsion # / subluxation
144
lisfranc injury mx
orif
145
lisfranc injury dx
AP & oblique XR + CT
146
what is claw toe
MTPJ hyperextension, PIPJ/DIPJ hyperflexion
147
what is mallet toe
MTPJ hyperextension, PIPJ hyperflexion, DIPJ hyperextension
148
what foot fracture isn't seen on xr (seen on mri)
talar dome fracture
