Flashcards in Intro to Ortho Deck (24):
patients presenting with MSK problems usually have one of the following:
What does a PE include for ortho?
Presence of swelling:
effusion = ?
softe tissue swelling =?
effusion = intraarticular
soft tissue swelling - extraarticular
bursa= "goose egg"
how should you measure ROM?
with a goniometer
describe the manual muscle 5 point scale:
5 - normal
4+= submax agaisnt resistance
4= mod against resistance
4-= slight against resistance
3= movement against gravity, but not resistance
2= movement with gravity eliminated (hand turned to side)
1= flicker of movement
0 = no movment
when is neuromuscular status particularly important?
long bone imaging should include the joints ____ and ____ injury
above and below the injury
images should be obtained in at least ____ planes _____ to each other
two planes perpendicular to each other
When do you use radiography? when do you not use radiography?
o Injury or deformity of a bone or joint
o Inability to use the extremity or joint
o Unexplained pain and localized tenderness in a bone or joint
o Follow-up of MSK disease
o Musculoskeletal conditions that involve primarily soft tissues in early stages or that produce minimal to no changes in the bone
• e.g. patellar chondromalacia
what is radiolucent?
o Radiolucent: Descriptive term indicating permeability of the x-ray beam through a structure
• Soft tissues
o Radiopaque: Descriptive term indicating impermeability of x-rays through a structure
• Metallic Hardware
What is MRI good for?
superior contrast resolution
good for soft tissues
**gadolinium--> safer than iodine based dyes and can be used in renal insufficiency
- GOOD FOR MARROW (m= marrow, mri)
What are the limitations of an MRI?
- prone to more artifact such as motion blur and metal scatter
MAGNET IS NOT COMPATIBLE WITH PACEMAKERS, HEART VALVES, METAL FB IN EYE, TATTOOS
- can take a long time
What is T1 and T2?
uses X-rays to produce slices.
What are the advantages of CTs:
higher contrast resolutions
lower cost than MRI
produces good images of the lung and bone
can be turned digital
what are the limitations of CT?
produces a variety of artifacts
soft tissue contrast is not as good as MRI
requires large physical space
exposure to radiation
What is a bone scan?
a form of nuclear medicine imaging
radioisotope labled IV drug acts as tracer of biologic activity
drug distributes itself according to targeted metabolic mechanisms.
how does a bone scan distribute?
1. intial (transient)
2. blood pool
3. delayed --> at least 2-4 hours
(tracer accumulates in tissues with active phosphate turnover--> bone undergoing turnover or growth).
what does a negative bone scan exclude?
fractures, metastases and osteomyelitis
when might you use orthography:
- rotator cuff tear
-interosseous ligament tears at the wrist
- meniscal tears
what are the two categories that a musculoskeletal injury has been classified into?
what are the two main oral anti-inflammatory medicines used in MSK injuries?
who should corticosteroids NEVER been injected into?
1. young athlete's joints
2. major joints if NO degenerative changes exist
3. major load bearing tendons (achilles, patellar)